Clival chordoma: A rare finding in children

Abstract

An eleven-year-old girl was referred to a pediatrician because of a persistent headache. Physical examination was normal. Magnetic resonance imaging (MRI) of the brain showed a 2 cm sharply delineated mass in the caudal part of the clivus, at the height of the basion, with low signal-intensity on T1-weighted imaging. On T2-weighted imaging, the lesion appeared heterogeneously hyperintense (Figure 1, arrow), without any signal suppression on the fluid-attenuated inversion recovery (FLAIR) sequence. There was a strong heterogenous contrast enhancement (Figure 2, arrow). Computed tomography (CT) showed a sharply delineated soft-tissue mass, with neither calcification nor bone tissue (Figure 3, arrow). No other osteolytic bone lesion was detected. Based on imaging findings, the diagnosis of chordoma was proposed. The lesion was resected surgically and the diagnosis of chordoma was confirmed on histology. Postoperatively, the patient underwent several sessions of radiation therapy and is currently under follow-up, free of relapse.