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Intradural clival chordoma and ecchordosis physaliphora: a challenging differential diagnosis: case report.
- Source :
-
Neurosurgery [Neurosurgery] 2009 Feb; Vol. 64 (2), pp. E387-8; discussion E388. - Publication Year :
- 2009
-
Abstract
- Objective: Purely intradural clival chordomas are rare neoplasms, and only a few cases have been reported. The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique.<br />Clinical Presentation: A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement.<br />Intervention: The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma.<br />Conclusion: Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only if a regrowth of the remnant is seen during neuroradiological follow-up.
- Subjects :
- Chordoma chemistry
Cranial Fossa, Posterior pathology
Cranial Fossa, Posterior surgery
Diagnosis, Differential
Humans
Male
Memory Disorders etiology
Middle Aged
Brain Stem Neoplasms diagnosis
Brain Stem Neoplasms surgery
Chordoma diagnosis
Chordoma therapy
Memory Disorders diagnosis
Memory Disorders prevention & control
Neuroendoscopy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4040
- Volume :
- 64
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 19190444
- Full Text :
- https://doi.org/10.1227/01.NEU.0000337064.57270.F0