J Korean Soc Radiol.  2018 Sep;79(3):175-180. 10.3348/jksr.2018.79.3.175.

Imaging Findings of a Nonenhancing Intradural Paramedian Chordoma Mimicking an Epidermoid Cyst

• Kim MJ
• Park YW
• Lim SM

• KMID: 2418660
• DOI: http://doi.org/10.3348/jksr.2018.79.3.175

Abstract

Intracranial chordoma is a rare tumor, originating from embryonic remnants of the primitive notochord. It typically appears as an enhancing extradural midline tumor with bone involvement. We introduce a rare case of a 27-year-old male who had a nonenhancing intradural chordoma showing paramedian location, involving the left cavernous sinus, Meckel's cave, and prepontine cistern. The pathologic diagnosis was confirmed as an intradural chordoma. The imaging findings of this unusual case of a nonenhancing intradural paramedian chordoma will be presented with the differential diagnosis focused on the epidermoid cyst.

MeSH Terms

Adult
Cavernous Sinus
Chordoma*
Diagnosis
Diagnosis, Differential
Epidermal Cyst*
Humans
Magnetic Resonance Imaging
Male
Notochord

Figure

• 

  Fig. 1 A 27-year-old man with a nonenhancing intradural paramedian chordoma. A. The mass shows low signal intensity on precontrast enhanced T1-weighted images, high signal intensity on T2-weighted images, and iso- to high signal intensity on fluid-attenuated inversion recovery images. The mass does not show any enhancement on postcontrast enhanced T1-weighted images. B. On diffusion weighted images, the mass demonstrates high signal intensity with slightly low apparent diffusion coefficient value on apparent diffusion coefficient map. C. On brain computed tomography, a multilobular low attenuating mass is noted at the left cavernous sinus and left Meckel's cave. There is no evidence of bone erosion, demonstrating on bone window images. D. On histologic specimen, the tumor contains physaliferous tumor cells with abundant myxoid stroma. There is no evidence of necrosis (Hematoxylin and eosin stain, × 200). E. The cells were positive in immunohistochemistry staining for pancytokeratin, S-100, EMA, and Ki-67 (MIB-1) (× 400). EMA = epithelial membrane antigen, MIB-1 = markers of cell proliferation

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