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Chordoma - clivus

Case contributed by Frank Gaillard
Diagnosis certain
ct

CT demonstrates a large destructive isodense soft tissue mass arising from the clivus and extending both anteriorly into the sphenoid sinus and posteriorly into the pre pontine cistern, where it indents the pons and displaces the basilar artery to the left.

mri

MRI demonstrates a large destructive soft tissue mass arising from the clivus and extending both anteriorly into the sphenoid sinus and posteriorly into the prepontine cistern, where it indents the pons and displaces the basilar artery to the left. The pituitary gland is elevated by the mass and can be seen to be separate from it. 

The mass shows low T1 and high T2 signal and demonstrates strong contrast enhancement. Features are consistent with a chordoma.

Case Discussion

This case demonstrates fairly characteristic imaging features of a clival chordoma which was subsequently histologically confirmed. 

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