Clival masses

The differential of a mass involving or arising from the clivus is a relatively narrow one and can be divided into whether the lesion arises from the skull base itself, the intracranial compartment above or the base of skull below.

When evaluating the clivus it is important to compare the marrow signal to that of the adjacent pons on non-contrast, non-fat saturated T1 sequences. Sagittal projection is most useful 3. See: normal bone marrow signal of the clivus.

  • metastasis
    • aggressive soft tissue mass
    • often patient has a known malignancy
  • chordoma
  • chondrosarcoma
    • paramedian, arising from the petro-occipital fissure 
    • also bright on T2 (chondroid matrix)
    • intralesional calcifications in >50%
    • elevated pituitary out of pituitary fossa
  • plasmacytoma
    • T2 signal low to intermediate
  • intraosseous lymphoma
  • neuroenteric cyst 2
    • can be located with in the base of skull or in the intracranial compartment
    • signal intensity varies depending on content
Share article

Article information

rID: 4614
Section: Gamuts
Synonyms or Alternate Spellings:
  • Clival lesions
  • Clival mass
  • Clival lesion
  • Clival tumours
  • Clivus mass
  • Clivus lesion

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1: chordoma
    Drag here to reorder.
  • Case 2: macroadenoma
    Drag here to reorder.
  • Case 3: clival meningioma
    Drag here to reorder.
  • Chondrosarcoma T1...
    Case 4: chondrosarcoma
    Drag here to reorder.
  • Case 5: nasopharyngeal carcinoma
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.