Sequential approaches for resection of clival chordoma

Abstract

INTRODUCTION: Chordomas are extra-axial tumours that originate from the primitive notochord. They are rare diseases that present mostly between the third and the fifth decades of life with an incidence rate of 0.08 per 100,000 in the United States. Approximately 35% of chordomas arise in the clivus of the skull base (clival chordoma). In spite of their slow-growing and non-malignant histopathological appearance, they are potentially life threatening due to their locally destructive and invasive nature. Clival chordomas are located near the spheno-occipital junction at the base of the skull, behind the sphenoid sinuses. Involvement of the surrounding cranial nerves accounts for their symptomatology. It is notorious for its high tendency of recurrence following treatment, with a reported recurrence rate of 68%. Therefore, gross total resection in combination with adjuvant radiotherapy is the standard mode of treatment …