Removal of giant clival chordoma by an anterior cervical approach

Chordoma, a primary malignant neoplasm of the cerebro-spinal axis, is difficult to diagnose and impossible to cure. The only effective treatment is early radical surgical removal, regardless of its size or location. A giant, 65gm tumor arising from the clivus, C1 and C2 vertebrae was successfully removed with low morbidity. The surgical technique is described and compared to other operations with their advantages and disadvantages. A plea is made for surgical removal as the initial treatment for these lesions to prevent fatal intracranial metastasis.