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Ecchordosis physaliphora

Case contributed by Paul Simkin
Diagnosis probable

Presentation

Incidental lesion.

Patient Data

Age: 40
Gender: Female
mri

MRI brain (with contrast)

Technique:

Multiplanar, multisequence imaging has been obtained through the brain including pre and post contrast sequences.

Findings:

There is a retro-clival non-enhancing cystic lesion seen to the left of the basilar artery in the pre-pontine cistern; this is stable in size at 10 x 8 mm. To the right of the cystic lesion a 6 x 5 mm region isointense to white matter on T2/FLAIR; this is most likely related to altered CSF flow. A small bony spur is noticed arising from the posterior aspect of the clivus at the level of the lesion as seen on the CT scan dated 09/11/2011, this is compatible with the osseous stalk of ecchordosis Physaliphora. The adjacent vertebral artery has a normal appearance.

No change in the remaining brain parenchyma.

Conclusion:

Stable appearance to the retro-clival cystic lesion with imaging appearance suggestive of ecchordosis physaliphora

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