Chordoma - clivus
Presentation
Upper cervical/base of skull pain.
Patient Data
Prominence of the soft tissue in the posterior nasopharynx in this age group most likely represents lymphoid tissue.
The dens and lateral masses of C1 are difficult to discern.
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CT reveal extensive bony destruction involving the inferior clivus, occipital condyles, C1 and C2. A large midline soft tissue mass is demonstrated on the soft tissue CT windows. No intratumoral calcifications are identified in this case.
Increased upstake in the region of the upper cervical spine.
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Case Discussion
The mass was biopsied and confirmed the diagnosis of chordoma.
Although chordomas are typically seen in young adults they need to be considered at all age groups, especially when a mass with high T2 signal is encountered, a fairly characteristic appearance.
Case courtesy of Bob Cook, MD. Western Memorial Regional Hospital Corner Brook, Newfoundland.