Bilateral abducens nerve palsies from clivus chordoma

An 87-year-old male complaining of horizontal diplopia of five months duration was found to have bilateral abducens nerve palsies. The remainder of the neurologic examination was unremarkable, but neuroradiologic investigation disclosed a lesion involving the sella and sphenoid sinus, with erosion of the upper aspect of the clivus. A large chordoma was found at trans-sphenoidal surgery. This presentation is unique in that the chordoma produced bilateral sixth-nerve palsies with no other neurologic defects.