Case 001

History/Physical

History/Physical:

51-year-old right-handed male.

Headache and neck pain for one year.

There is a mildly expansile lesion in the clivus right of midline (*). The margin is corticated but also mildly irregular.

The mass is heterogenously hyperintense on T2 (*).

There is a well-defined enhancing mass (*) posterior to the pituitary gland (arrow) and medial to the right ICA (arrowhead).

The lesion involves the dorsum sella (*). The pituitary gland is displaced anteriorly.

In comparison to the unenhanced sagittal T1, there is moderate enhancement (*).

Diagnosis: Chordoma

Lobular architecture

Tumour cell cytoplasm is extensively vacuolated or "physaliferous" (arrow)

Vimentin expression is diffuse and variable in intensity

S-100 protein expression is diffuse and variable in intensity

Cytokeratin (CKCAM5.2) expression is strong and diffuse