clivus chordoma shirley h. wray, m.d., ph.d. professor of neurology, harvard medical school...
Post on 21-Dec-2015
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HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY
MASSACHUSETTS GENERAL HOSPITAL
HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY
MASSACHUSETTS GENERAL HOSPITAL
HARVARD MEDICAL SCHOOLDEPARTMENT OF NEUROLOGY
MASSACHUSETTS GENERAL HOSPITAL
Clivus Chordoma
Shirley H. Wray, M.D., Ph.D. Professor of Neurology, Harvard Medical School
Director, Unit for Neurovisual DisordersMassachusetts General Hospital
Neuroimaging
Figure 1 - Axial CECT scan shows destructive central skull base lesion that expands the cavernous sinus and encases both internal carotid arteries.
Neuroimaging
Figure 2 - Sagittal pre-contrast T1-weighted MR shows the lesion is mostly hypointense compared to brain. Note destruction of posterior clivus with extension to the pons.
Neuroimaging
Figure 3 - Coronal T2WI shows the lesion is extremely hyperintense, characteristic of most chordomas. Note elevation and encasement of both carotid arteries.
Neuroimaging
Figure 4 - Sagittal post-contrast T1-weighted MR shows the lesion enhances strongly but inhomogeneously.
Pathology
chordoma.jpg
Chordomas are characterized by cords of physaliferous cells with mucinous vacuoles. They often occur in the clival, sellar, and sphenoid regions and cause bony destruction.