HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY

MASSACHUSETTS GENERAL HOSPITAL

HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY

MASSACHUSETTS GENERAL HOSPITAL

HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY

MASSACHUSETTS GENERAL HOSPITAL

Clivus Chordoma

Shirley H. Wray, M.D., Ph.D. Professor of Neurology, Harvard Medical School

Director, Unit for Neurovisual DisordersMassachusetts General Hospital

Neuroimaging

Figure 1 - Axial CECT scan shows destructive central skull base lesion that expands the cavernous sinus and encases both internal carotid arteries.

Neuroimaging

Figure 2 - Sagittal pre-contrast T1-weighted MR shows the lesion is mostly hypointense compared to brain. Note destruction of posterior clivus with extension to the pons.

Neuroimaging

Figure 3 - Coronal T2WI shows the lesion is extremely hyperintense, characteristic of most chordomas. Note elevation and encasement of both carotid arteries.

Neuroimaging

Figure 4 - Sagittal post-contrast T1-weighted MR shows the lesion enhances strongly but inhomogeneously.

Pathology

chordoma.jpg

Chordomas are characterized by cords of physaliferous cells with mucinous vacuoles. They often occur in the clival, sellar, and sphenoid regions and cause bony destruction.

http://library.med.utah.edu/NOVEL/Wray/