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Ecchordosis Physaliphora: Does It Even Exist?
A R Stevens1, B F Branstetter2,3, P Gardner4
1From the Lake Erie College of Osteopathic Medicine (A.R.S.), Erie, Pennsylvania.
AJNR. American Journal of Neuroradiology
|July 13, 2023
Summary
Ecchordosis physaliphora (EP) and low-grade chordomas share similar imaging features, causing diagnostic challenges. This review proposes updated terminology for clearer radiologic diagnosis and improved patient care.
Area of Science:
- Neurosurgery
- Radiology
- Pathology
Background:
- Ecchordosis physaliphora (EP) is a benign notochordal remnant typically found in the clivus.
- Radiologic differentiation between EP and low-grade chordomas is challenging due to overlapping imaging features.
- Chordomas have growth potential, necessitating accurate diagnosis for appropriate management.
Approach:
- Review current pathologic terminology for notochordal remnants.
- Propose new radiologic terms to address diagnostic uncertainty.
- Discuss the clinical significance of accurate terminology in surgical decision-making.
Key Points:
- The historical term ecchordosis physaliphora (EP) lacks specificity in radiologic interpretation.
- Distinguishing EP from low-grade chordomas is critical due to differing prognoses and treatment strategies.
- New terminology aims to improve diagnostic accuracy and guide surgical interventions.
Conclusions:
- Updated pathologic and radiologic terminology is essential for precise diagnosis of clival notochordal lesions.
- Clearer diagnostic terms will enhance communication between radiologists, pathologists, and surgeons.
- Accurate terminology directly impacts patient care by informing treatment decisions and surgical planning.
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