Skull Base 2008; 18(6): 395-399
DOI: 10.1055/s-0028-1087221
CASE REPORT

© Thieme Medical Publishers

Cerebrospinal Fluid Rhinorrhea Secondary to Ecchordosis Physaliphora

Adebayo Alli1 , Matthew Clark2 , Nicholas J. Mansell3
  • 1Department of Anatomy, Academic Centre, Henriette Raphael Building, Guy's Campus, King's College, London, United Kingdom
  • 2Department of Otolaryngology, John Radcliffe Hospital, Oxford, United Kingdom
  • 3Department of Otolaryngology, Royal Berkshire Hospital, Reading, Berkshire, United Kingdom
Further Information

Publication History

Publication Date:
07 October 2008 (online)

ABSTRACT

Ecchordosis physaliphora is a rare hamartomatous lesion of notochord origin that is usually asymptomatic. In this case report, such a lesion arose at the clivus, with extension through to the sphenoid sinus. As a result, it presented with cerebrospinal fluid rhinorhea, making the case particularly unusual. We describe the treatment for this rare situation and discuss its differentiation from chordoma, its malignant counterpart.

REFERENCES

  • 1 Sassin J F. Intracranial chordoma. In: Vinken PJ, Bruyn GW Handbook of Clinical Neurology. Vol. 18. Amsterdam; North Holland 1975: 151-164
  • 2 Wolfe J T, Scheithauer B W. “Intradural chordoma” or “giant ecchordosis physaliphora”? Report of two cases.  Clin Neuropathol. 1987;  6 98-103
  • 3 Ho K L. Ecchordosis physaliphora and chordoma: a comparative ultrastructural study.  Clin Neuropathol. 1985;  4 77-86
  • 4 Stam F C, Kamphorst W. Ecchordosis physaliphora as a cause of fatal pontine haemorrhage.  Eur Neurol. 1982;  21 90-93
  • 5 Luschka H. Die Altersveranderungen der Zwischenwirbelknorpel.  Virchows Arch A. 1856;  9 311-327
  • 6 Virchow R. Untersuschungen über die Entwickelung des Schädelgrundes im Gesunden und Krankhaften zur Tande und über den Einfluss Derselbe auf Schädelform, Gesichtsbildung und Gehirnbau. Berlin; G Reimer 1857: 47
  • 7 Müller H. Über das Vorkommen von Resten der Chorda Dorsalis bei Menschen nach der Geburt und über ihr Verhältnis zu den Gallertgeschwulsten am Clivus.  Z Rat Med. 1858;  2 202-229
  • 8 Ribbert H. Über die Ecchondrosis Physalifora Sphenooccipitalis.  Zentralbl Allg Path. 1894;  5 457-461
  • 9 Rutherfoord G S, Davies A G. Chordomas—ultrastructure and immunohistochemistry: a report based on the examination of six cases.  Histopathology. 1987;  11 775-787
  • 10 Ling S S, Sader C, Robbins P, Rajan G P. A case of giant ecchordosis physaliphora: a case report and literature review.  Otol Neurotol. 2007;  28 931-933
  • 11 Wright D. Nasopharyngeal and cervical chordoma—some aspects of their development and treatment.  J Laryngol Otol. 1967;  81 1337-1355
  • 12 Macdonald R L, Cusimano M D, Deck J, Gullane P J, Dolan E J. Cerebrospinal fluid fistula secondary to ecchordosis physaliphora.  Neurosurgery. 1990;  26 515-519
  • 13 Mehnert F, Beschorner R, Küker W, Hah U, Nägele T. Retroclival ecchordosis physaliphora: MR imaging and review of the literature.  AJNR Am J Neuroradiol. 2004;  25 1851-1855
  • 14 Bartolini G. Il cordoma del clivus quale causa di emorragia cerebrale: discussione anatomo-clinica su di una osservazione autopica.  Boll Soc Ital Biol Sper. 1974;  50 912-918
  • 15 Mapstone T B, Kaufman B, Ratcheson R A. Intradural chordoma without bone involvement: nuclear magnetic resonance (NMR) appearance. Case report.  J Neurosurg. 1983;  59 535-537
  • 16 Preece M T, Osborn A G, Chin S S, Smirniotopoulos J G. Intracranial neurenteric cysts: imaging and pathology spectrum.  AJNR Am J Neuroradiol. 2006;  27 1211-1216
  • 17 Crockard H A et al.. A multidisciplinary team approach to skull base chordomas.  J Neurosurg. 2001;  95 175-183
  • 18 Chang S W, Gore P A, Nakaji P, Rekate H L. Juvenile intradural chordoma: case report.  Neurosurgery. 2008;  62 E525-E526 discussion E527

Dr. Adebayo AlliM.B.B.Ch. 

Honorary Anatomy Demonstrator, Department of Anatomy, Academic Centre, Henriette Raphael Building

Guy's Campus, King's College, London SE1 1UL, United Kingdom

Email: bayoalli@doctors.org.uk

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