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Ecchordosis Physaliphora
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Demographics: 56 years old, Male
Indication: Fall

Ecchordosis Physaliphora

Findings

  • Well-marginated lucent lesion involving the right eccentric and dorsal clivus with an osseous excrescence/stalk projecting posteriorly from the left eccentric clivus.

Diagnosis

Ecchordosis Physaliphora

Discussion

  • Indolent congenital benign mass which comes from notochord remnants.  Oftentimes found incidentally.

    • Cystic mass, most commonly located along the dorsal aspect of the clivus.  Typically well-marginated without aggressive features.  Oftentimes has an intradural component within the adjacent pre-pontine cistern that may not be apparent on CT and better characterized by MRI.  May have an osseous stalk connecting the clival and intradural components (as in this case).

    • Can be difficult to differentiate from a Chordoma.  If the patient has a primary malignancy, consider metastasis.

Annotated Images & Illustrations

Ecchordosis Physaliphora

Ecchordosis Physaliphora

Ecchordosis Physaliphora

Ecchordosis Physaliphora

mri

mri

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