A case of intracranial chordoma with a special reference to the findings in computed tomography

A case of chordoma was reported with a special reference to the computed tomography. A 22-year-old female, who had been in good health, was admitted to Kagoshima University Hospital on December 8, 1978 with a chief complaint of diplopia. Physical examination was nothing particular and neurologic examination revealed the left abducent nerve palsy. The laboratory findings including blood count, serum electrolytes, hormonal study, carcinoembryonic antigen (CEA) and α-fetoprotein were within normal limits. Plain skull films showed a retro-sellar calcification in combination with a bony erosion of the dorsum sellae and the clivus. The left vertebral arteriography and the left carotid arteriography showed a space taking lesion extended from the retro-clival to the left parasellar region. The axial CT scanning showed a round and irregular high density area consistent with calcification, at the retro-clival area, middle cranial fossa, and parasellar region in the left side, and no enhancement effect was acquired. The coronal CT appearance showed a round but discontinuous high density area like a coral reef, based on the clivus. These CT findings indicated the extension of the space taking legion, clearly. Intracapsular removal of the tumor was performed and histologic examination confirmed the chordoma. It will be emphasized that CT scan, particularly coronal section was one of the most useful diagnostic procedure of mass of the skull base. (author)