EURORAD ESR

Case 13890

Clival chordoma - CT and MRI

Author(s)
Pablo Naval-Baudin1, Mònica Cos Domingo2

1Department of Radiology,
2Department of Neuroradiology.
Institut de Diagnòstic per la Imatge - IDI

Hospital Universitari de Bellvitge
Feixa Llarga s/n 08907
L'Hospitalet de Llobregat
Barcelona, Spain

* Contact: pnaval@bellvitgehospital.cat
 
Patient
female, 70 year(s)
 
 
  • Figure 1
    NECT and CECT
     

    Infiltrative clival lesion with intralesional calcifications, some chondroid-like (dots-&-commas). Invades posterior nasopharynx, carotid canals (a), and endocranium, bulging and "thumbprinting" the anterior aspect of...

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Infiltrative clival lesion with intralesional calcifications, some chondroid-like (dots-&-commas). Invades posterior nasopharynx, carotid canals (a), and endocranium, bulging and "thumbprinting" the anterior aspect of...

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Fig 1c. CECT shows heterogeneous, honeycomb-like enhancement of the clival lesion (c).

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    MRI
     

    Axial T1SE. Homogeneously intermediate-hypointensity. Right carotid artery encasement.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Coronal T2TSE. Heterogeneously hyperintense with cystic foci.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T1+contrast. Heterogeneous “honeycombing” enhancement, with a predominantly peripheral distribution. Endocraneal invasion is evident, with pontine "thumbprinting".

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    DWI. Discrete hyperintensity of the lesion.

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    ADC map. Region of interest (red circle) relatively low ADC values (615E-6 +/- 65E-6 mm^2/s).

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Infiltrative clival lesion with intralesional calcifications, some chondroid-like (dots-&-commas). Invades posterior nasopharynx, carotid canals (a), and endocranium, bulging and "thumbprinting" the anterior aspect of the pons (b). Also invades both cavernous venous sinuses (b).
 
Infiltrative clival lesion with intralesional calcifications, some chondroid-like (dots-&-commas). Invades posterior nasopharynx, carotid canals (a), and endocranium, bulging and "thumbprinting" the anterior aspect of the pons (b). Also invades both cavernous venous sinuses (b).
 
Fig 1c. CECT shows heterogeneous, honeycomb-like enhancement of the clival lesion (c).
 
Axial T1SE. Homogeneously intermediate-hypointensity. Right carotid artery encasement.
 
Coronal T2TSE. Heterogeneously hyperintense with cystic foci.
 
Sagittal T1+contrast. Heterogeneous “honeycombing” enhancement, with a predominantly peripheral distribution. Endocraneal invasion is evident, with pontine "thumbprinting".
 
DWI. Discrete hyperintensity of the lesion.
 
ADC map. Region of interest (red circle) relatively low ADC values (615E-6 +/- 65E-6 mm^2/s).
 
 
 
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