Skull Base Chordoma with Intradural Component and Compression to Pons

Chordoma is a rare primary bone tumor derived from transformed notochord remnants. It has a local aggressive behavior and high recurrence rates. Treatment of skull base chordomas is complex and challenging. Control of the disease relies mainly on surgical excision of the tumor, sometimes followed by high-dose radiation therapy. The main surgical goal is to achieve maximal tumor removal with minimal morbidity. Development of the expanded endoscopic endonasal approach has improved surgical and prognostic results of skull base chordomas.

The endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications.

We report our experience with endoscopic extended endoscopic transsphenoidal approaches for the treatment of cranial base chordoma which compress pons significantly and appears with intradural component.

A 35-year-old male patient admitted with headache and transient upper extremity weakness. MRI investigation shows clival chordoma with intradural component and extension toward pons.

Patient underwent transnasal transsphenoidal endoscopic surgery. The ETT approach provides a panoramic view of the cavernous internal carotid artery (ICA) and parasellar cavernous sinus, as well as an exquisite anatomic view of the optic nerve, pituitary, petrous ICA, and upper-middle clivus The extended. ETT approach not only provided an excellent view of the regions, but also provides a good view of the above-mentioned contralateral structures and the lower clivus. Tumor is removed totally. Intraoperative or postoperative complications wasn't observed. Patient accepted adjuvant radiotherapy and 6 months of follow-up shows patient is tumor free.

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Publication History

Article published online:
12 February 2021