Cranial chordomas

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Abstract
The clinical and radiological features of 44 cranial chordomas are recorded. Classical features of a mid line partially calcified tumor, destroying the clivus and causing a soft tissue mass in the sphenoid sinus or nasopharynx were present in about half of the cases. The high incidence of unilateral bone erosion which occurred in nearly a 1/3 of the cases, the diagnostic significance of erosion of the tip of the clivus and odontoid peg and the not infrequent sclerotic bone reaction to the tumor, are stressed. Increased uptake of 99mTc occurred in 5 cases in which encephalography was performed. Computed transmission tomography was valuable not only in showing intracranial extension of the tumors and changes in the ventricular system, but also in outlining the extent of the mass within the skull base. Chordomas tend to displace the dura before transgressing it so that the subarachnoid space is usually patent adjacent to large tumors allowing the margins of any intracranial or spinal extension to be outlined at encephalography or myelography. Displacements of basal vessels are helpful in confirmation of the site and extent of the tumor. Narrowing of arteries by compression is not infrequent but encasement is rare. Pathological circulation which was not considered to be a feature of chordomas was shown in 6 cases.