Intradural drop metastasis of a clival chordoma

A 69-year-old man with a history of clival chordoma presented with cauda equina syndrome. A mass impinging on the cauda equina was detected on MRI scans and it was initially thought to be a sequestered disc. A decompressive laminectomy was performed revealing the mass to be a haematoma containing abnormal tissue. Immunohistochemical analysis showed the tissue to be a chordoma. Intradural drops are a rare mode of metastasis for intracranial chordomas. Despite their rarity it may be advisable to include spinal scans for patients with intracranial chordomas, as early detection may lead to improved clinical outcomes.