Intradural invasion of chordoma: two case reports

Area of Science:

• Neuro-oncology
• Neurosurgery
• Pathology

Background:

• Chordomas are rare, slow-growing bone tumors originating from notochordal remnants, typically found in the axial skeleton.
• Intracranial chordomas, particularly those in the clivus, pose diagnostic and surgical challenges due to their location and potential for invasion.

Observation:

• Two patients with intracranial chordomas involving the clivus and prepontine cisterns presented with cranial neuropathies and headaches.
• Surgical resection via petrosal approaches was performed, achieving radical tumor removal.
• Post-operative MBI-1 studies aided in differentiating chordoma from ecchordosis physaliphorae, a similar-appearing non-neoplastic entity.

Findings:

• Anatomopathological examination confirmed chordoma in both patients.
• Both patients experienced complete symptom resolution and remained recurrence-free at 18 months post-surgery.
• The study highlights the efficacy of surgical intervention for chordomas in this region.

Implications:

• Petrosal approaches are effective for radical resection of intracranial chordomas.
• Accurate differentiation from ecchordosis physaliphorae is crucial for appropriate management.
• Timely diagnosis and treatment of chordomas can lead to favorable patient outcomes.