Expand ("E")   Collapse

Age: 56

Sex: Male

Indication: Fall

Ecchordosis Physaliphora

Mimicking Malignancy



Findings Relating to the Mimic

  • Well-marginated lucent lesion involving the right eccentric and dorsal clivus with an osseous excrescence/stalk projecting posteriorly from the left eccentric clivus.


Discussion

  • Indolent congenital benign mass which comes from notochord remnants.  Oftentimes found incidentally.
  • Cystic mass, most commonly located along the dorsal aspect of the clivus.  Typically well-marginated without aggressive features.  Oftentimes has an intradural component within the adjacent pre-pontine cistern that may not be apparent on CT and better characterized by MRI.  May have an osseous stalk connecting the clival and intradural components (as in this case).
  • Can be difficult to differentiate from a Chordoma.  If the patient has a primary malignancy, consider metastasis.


Images

Well-marginated lucent lesion involving the right eccentric and dorsal clivus Posteriorly direct bony stalk (red arrows) along the left posterior aspect of the cystic clival lesion. Subsequent MRI nicely shows the T2 hyperintense cystic mass in the right-eccentric clivus (white arrows) and the associated posteriorly directed osseous stalk (red arrow)

📣 Feedback?

⌨️  Keyboard Shortcuts ("K")

⌨️ Keyboard Shortcuts

View shortcuts

Zoom/Pan

  Full screen

  Window/Level

  Expand/collapse

  Scroll

  Save the case

  Close case/tab

Previous Slice (Scroll)

Next Slice (Scroll)

 Toggle presets

 Previous series (if multiple)

 Next series (if multiple)

  Previous case (⌘ ◄ on a mac)

  Next case (⌘ ► on a mac)