Ecchordosis physaliphora

Case contributed by Dr Andrew Lawson

Presentation

Incidental finding during work-up for a pituitary lesion.

Patient Data

Age: 40
Gender: Male
MRI

The hypoenhancing pituitary lesion measuring 6 x 7 x 7 mm is unchanged in appearance and size. The pituitary gland is bulky with a convex contour superiorly but there is no contact or exert mass effect on the optic nerves or chiasm. The cavernous sinuses enhance normally. The infundibulum is mildly deviated to the right, unchanged.

The T2 hyperintense lesion of the dorsum sellae is unchanged (stable over 3 years), with loss of normal fat signal and cortical destruction posteriorly. Mild enhancement.

Conclusion:

1. Stable pituitary adenoma.

2. the lesion related to the dorsum sella represents an ecchordosis physaliphora. Slightly unusual that is demonstrates some ill defined enhancement.

CT

Erosions demonstrated on CT.

Case Discussion

Benign nodule of tissue in prepontine cistern dorsal to clivus considered to be ectopic notochordal remnant.

Top differential diagnoses:

Pathology

  • Few clear cells ("physaliphorous cells") surrounded by chondromyxoid stroma.
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Case information

rID: 26768
Case created: 7th Jan 2014
Last edited: 1st Jul 2016
Inclusion in quiz mode: Included

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