Magnetic resonance imaging of ecchordosis physaliphora--case report

A rare case of ecchordosis physaliphora clearly demonstrated by magnetic resonance (MR) imaging is described in a 48-year-old male who presented with right hearing disturbance and reduction in sensation in the right side of his face due to a large cystic schwannoma. MR imaging revealed the large cystic schwannoma as well as an abnormal clival lesion. The clival lesion was hypointense on T1-weighted images and hyperintense on T2-weighted images, and not enhanced by gadolinium-diethylenetriamine-penta-acetic acid (Gd-DTPA) administration. The clival lesion was partially removed. The histological diagnosis was ecchordosis physaliphora. The postoperative course was uneventful. The absence of enhancement of ecchordosis physaliphora by Gd-DTPA administration may be a characteristic finding, in contrast to chordoma which is generally enhanced.