Chordoma

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  • 50-year-old patient presented with neck pain and a left arm radiculopathy.
  • A hyperintense and expansile lesion filling the C6 vertebral body caused compression of the left C7 nerve root.

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  • 30-year-old patient 3 month history of neck pain and crepitus.
  • MRI showed an expansile enhancing lesion centred on the left side of the C3 vertebra.
  • The lesion was lucent on CT and metabolically active on FDG-PET.

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  • 60-year-old patient presented with visual impairment and clinical features of hypopituitarism.
  • MRI showed a minimally enhancing lesion replacing the superior clivus and pititary fossa.
  • The pituitary gland, infundibular stalk and optic chiasm were compressed.

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  • A 50-year-old patient presented with nasal obstruction.
  • MRI showed a lobulated mild enhancing lesion in the nasopharynx with erosion of the inferior cortex of the clivus.
  • 4 years later, a follow-up MRI showed no recurrence but many microhaemorrhages in the anterior temporal lobes and brainstem, which were likely to be related to radiotherapy.

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  • A 50-year-old patient presented with a visual field defect picked up during a routine eye test.
  • CT showed a large destructive lesion centred on the anterior clivus and pituitary fossa.
  • MRI showed an avidely enhancing clivus lesion that was compressing the right cisternal optic nerve.
  • With the differential including a pituitary macroadenoma, a chordoma was confirmed following a transphenoidal biopsy.