A practical overview of CT and MRI features of developmental, inflammatory, and neoplastic lesions of the sphenoid body and clivus

Nardi, Cosimo; Maraghelli, Davide; Pietragalla, Michele; Scola, Elisa; Locatello, Luca Giovanni; Maggiore, Giandomenico; Gallo, Oreste; Bartolucci, Maurizio

doi:10.1007/s00234-022-02986-x

Cited by 6 publications

(7 citation statements)

References 99 publications

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“…Chordomas are typically larger and more aggressive than EP, with imaging features including bone destruction, mass effect, and contrast enhancement [ 1 , 4 ]. Other differential diagnoses for EP include lipoma, meningioma, arachnoid cyst, Tarlov cyst, epidermoid cyst, dermoid cyst, and metastatic tumor [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Benign Long-Standing Ecchordosis Physaliphora

Alzahrani

2023

Cureus

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Ecchordosis physaliphora (EP) is a rare benign lesion arising from embryonic notochordal remnants, typically located in the retroclival region. This case report presents a 46-year-old male patient experiencing intermittent headaches and occipital pain. Imaging revealed a well-defined, smoothly corticated bony lesion on the left side of the clivus, accompanied by a characteristic bony stalk devoid of any aggressive features. A review of the patient's medical records indicated stable imaging findings of the lesion over six years. Clinicians and radiologists should be familiar with EP as a benign entity and differentiate it from aggressive pathologies.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Benign Long-Standing Ecchordosis Physaliphora

Alzahrani

2023

Cureus

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“…Ecchordosis physaliphora is a benign, congenital notochord remnant that warrants inclusion in this article given its potential diagnostic overlap with chordomas. This gelatinous, hamartomatous lesion is generally found at the dorsal clivus, to which it is attached by a bony or cartilaginous stalk 70 . Although the description of this as a clinical entity has historically largely been limited to case reports and small case series, autopsy series report the presence of ecchordosis physaliphora in up to 2% of autopsy specimens 71–73 …”

Section: Ecchordosis Physaliphoramentioning

confidence: 99%

“…As ecchordosis physaliphora cannot be reliably distinguished from chordoma by histopathologic features alone, the diagnosis hinges on the identification of common radiographic characteristics. Importantly, on MRI, ecchordosis physaliphora lesions are well-circumscribed dorsal and retroclival lesions that are hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, demonstrate the absence of contrast enhancement, do not have bony erosion, and may have a T2 hypointense pedicle or stalk 70,71 . Expectant management is appropriate for asymptomatic ecchordosis physaliphora lesions, which may be followed with serial imaging, whereas symptomatic lesions may warrant surgical consideration 73 …”

Section: Ecchordosis Physaliphoramentioning

confidence: 99%

“…This gelatinous, hamartomatous lesion is generally found at the dorsal clivus, to which it is attached by a bony or cartilaginous stalk. 70 Although the description of this as a clinical entity has historically largely been limited to case reports and small case series, autopsy series report the presence of ecchordosis physaliphora in up to 2% of autopsy specimens. [71][72][73] Clinical Presentation, Diagnosis, and Management of Ecchordosis Physaliphora Ecchordosis physaliphora is most commonly asymptomatic and thus found incidentally on CNS imaging obtained for unrelated symptoms; rarely, ecchordosis physaliphora may present with symptoms related to mass effect on neighboring structures.…”

Section: Ecchordosis Physaliphoramentioning

confidence: 99%

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Skull Base Tumors

Forst,

Jones

2023

CONTINUUM: Lifelong Learning in Neurology

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Objective This article reviews the presenting features, molecular characteristics, diagnosis, and management of selected skull base tumors, including meningiomas, vestibular schwannomas, pituitary neuroendocrine tumors, craniopharyngiomas, chordomas, ecchordosis physaliphora, chondrosarcomas, esthesioneuroblastomas, and paragangliomas. Latest Developments Skull base tumors pose a management challenge given their complex location and, as a result, the tumors and treatment can result in significant morbidity. In most cases, surgery, radiation therapy, or both yield high rates of disease control, but the use of these therapies may be limited by the surgical accessibility of these tumors and their proximity to critical structures. The World Health Organization classification of pituitary neuroendocrine tumors was updated in 2022. Scientific advances have led to an enhanced understanding of the genetic drivers of many types of skull base tumors and have revealed several potentially targetable genetic alterations. This information is being leveraged in the design of ongoing clinical trials, with the hope of rendering these challenging tumors treatable through less invasive and morbid measures. Essential Points Tumors involving the skull base are heterogeneous and may arise from bony structures, cranial nerves, the meninges, the sinonasal tract, the pituitary gland, or embryonic tissues. Treatment often requires a multidisciplinary approach, with participation from radiation oncologists, medical oncologists, neuro-oncologists, and surgical specialists, including neurosurgeons, otolaryngologists, and head and neck surgeons. Treatment has largely centered around surgical resection, when feasible, and the use of first-line or salvage radiation therapy, with chemotherapy, targeted therapy, or both considered in selected settings. Our growing understanding of the molecular drivers of these diseases may facilitate future expansion of pharmacologic options to treat skull base tumors.

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“…CT shows a well circumscribed lytic lesion with thickened and coarse trabecular pattern. On MRI, it is usually hyperintense on T1W and T2W images but may show atypical low signal on T1W and T2W [ 16 ].…”

Section: Tumorsmentioning

confidence: 99%

Sphenoid sinus anatomical variants and pathologies: pictorial essay

Sethi,

Choudhary,

Ganesan

et al. 2023

Neuroradiology

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The sphenoid sinus (SS) is one of the four paired paranasal sinuses (PNSs) within the sphenoid bone body. Isolated pathologies of sphenoid sinus are uncommon. The patient may have various presentations like headache, nasal discharge, post nasal drip, or non-specific symptoms. Although rare, potential complications of sphenoidal sinusitis can range from mucocele to skull base or cavernous sinus involvement, or cranial neuropathy. Primary tumors are rare and adjoining tumors secondarily invading the sphenoid sinus is seen. Multidetector computed tomography (CT) scan and magnetic resonance imaging (MRI) are the primary imaging modalities used to diagnose various forms of sphenoid sinus lesions and complications. We have compiled anatomic variants and various pathologies affecting sphenoid sinus lesions in this article.

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A practical overview of CT and MRI features of developmental, inflammatory, and neoplastic lesions of the sphenoid body and clivus

Cited by 6 publications

References 99 publications

A Rare Case of Benign Long-Standing Ecchordosis Physaliphora

A Rare Case of Benign Long-Standing Ecchordosis Physaliphora

Skull Base Tumors

Sphenoid sinus anatomical variants and pathologies: pictorial essay

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