Intradural retroclival chordoma

Abstract

A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.

Keywords: Chordoma; Intradural; Retroclival.

Fig. 1

Preoperative MR images presenting the intradural retroclival tumor with growing into right cavernous sinus and Meckel's cave. A : Axial T1-weigted imgae. B : Axial T-2 weighted image. C : Axial Gd-enhanced T1-weighted image. D : Sagittal Gd-enhanced T1-weighted image.

Fig. 2

Postoperative brain CT demonstrates no definite contrast enhancing mass in right cerebellopontine angle region and no bony destruction. A : Axial contrast enhanced brain CT image. B : Bone-setting image.

Fig. 3

Follow-up MR images at 1 month after operation demonstrates a remnant tumor. A : Axial Gd-enhanced T1-weighted image. B : Sagittal Gd-enhanced T1-weighted image.

Fig. 4

MR images, performed 14 months after gammaknife radiosurgery, representing decreased remnant tumor in size. A : Axial Gd-enhanced T1-weighted image. B : Sagittal Gd-enhanced T1-weighted image.

Fig. 5

Photomicrograph of the intradural tumor showing typical physaliphorous cells in mucinous matrix. H & E stain ×200 (A). Immunohistochemical stains showing expression of cytokeratin (B), and S-100 protein (C).