Article Figures & Data
Figures
- Fig 1.
A, A 65-year-old woman presented with nasal obstruction. Findings show atypical CT appearance of a pathology-proved extraosseous nasopharyngeal chordoma. Sagittal noncontrast CT scan shows a lobulated mass centered in the nasopharynx with superior extension into the sphenoid sinus (curved arrow) and focal erosion of the anterior clivus (black arrow). B, Axial bone CT scan shows a lobulated soft-tissue mass centered in the nasopharynx, with scalloping of the anterior margin of the clivus. Note the lytic appearance with a sclerotic margin (black arrow). C, Sagittal T1-weighted MR image shows a heterogeneous nasopharyngeal mass with a focal area of T1 hyperintensity (arrow) thought to represent blood products or proteinaceous debris. D, Sagittal T1-weighted MR image with contrast shows heterogeneous enhancement of the mass, which is an enhancement pattern seen in both extraosseous and typical skull base chordomas.
- Fig 2.
A 56-year-old man presented with a 2-year history of nasal obstruction. Axial noncontrast CT scan shows dystrophic calcification and a midline sinus tract (arrow), which can help with the preoperative diagnosis of extraosseous nasopharyngeal chordoma. This sinus tract is thought to represent tumor extending into the medial basal canal.
- Fig 3.
A 53-year-old man presented with dryness of mouth and difficulty breathing. Axial T2-weighted MR image with fat saturation shows a locally invasive heterogeneously hyperintense mass with internal septations (black arrow) centered in the nasopharynx, with invasion of the right masticator space, nasal cavity, and maxillary sinus. Note involvement of the anterior clivus (curved arrow), which may help preoperatively to diagnose this lesion as an extraosseous nasopharyngeal chordoma.
- Fig 4.
A, A 32-year-old woman presented with a mass in the nasopharynx. MR imaging shows a midline sinus tract extending into the clivus of a pathologically proved extraosseous nasopharyngeal chordoma. Axial bone CT scan shows a midline tract (curved arrow) representing the extension of the extraosseous chordoma into the medial basal canal. B, Axial T2-weighted MR image shows the hyperintense midline sinus tract (curved arrow) extending posteriorly from the nasopharyngeal mass. Note fluid in the left mastoid air cells secondary to obstruction of the eustachian tube due to a nasopharyngeal chordoma.
- Fig 5.
Graphic drawing of developing skull base ossification centers. Note that the craniopharyngeal canal is anterior to the spheno-occipital synchondrosis, whereas the medial basal canal (canalis basilaris medianus) is posterior to the synchondrosis. Reproduced with permission from Amirsys.
- Fig 6.
Sagittal graphic drawing shows the expected location of the notochordal remnant (blue line). Note the relationship of the spheno-occipital synchondrosis between the craniopharyngeal canal and the medial basal canal (short arrow). Extraosseous chordomas appear to arise from the extraosseous notochordal remnant. If these chordomas arise inferiorly, they may extend into the medial basal canal. Reproduced with permission from Amirsys.
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