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Flashcards in Skull Base Deck (4)
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What is a chordoma?

Neoplasm arising from the remnants of the notochord which presents as a destructive midline mass.
Most common locations: sacrum (50%), clivus (35%), vertebral bodies (most commonly C2).
Typically it is T2 bright and has a predilection for the spheno-occipital synchondrosis.
Main differential is chondrosarcoma.


Chondrosarcoma features.

1. Almost always just lateral to the midline
2. T2 bright but will have classic “arcs and rings” matrix on CT


What skull changes do you see in Paget’s?

1. Osteolysis circumscripta - large areas of osteolysis in the frontal and occipital bones in lytic phase
2. “Cotton wool” appearance in mixed phase
3. Thickened and expanded in sclerotic phase.


Skull base lesion differential.

1. Chordoma
2. Chondrosarcoma
3. Metastasis
4. Myeloma
5. Fibrous dysplasia
6. Paget’s disease