Ecchordosis physaliphora

Case contributed by Dr Yair Glick

Presentation

Left frontotemporal headache.

Patient Data

Age: 55 years
Gender: Male
CT

No evidence of intracranial hemorrhage or mass effect.

Lytic clival process with soft tissue component (24-26 HU) bulging anteriorly into sphenoid sinus and posteriorly into prepontine cistern. Corticated margin around part of the lesion. Unchanged compared to previous CT done exactly 2 years previously.

Small piece of metal shrapnel in superomedial preseptal right orbit abutting the globe and another one in the frontal scalp right of the midline.

Case Discussion

The location, the corticated margins, and the fact that the lesion had remained totally unchanged for two years, strongly favor ecchordosis physaliphora.

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