Ecchordosis physaliphora (EP) is a rare, benign tumor derived from the notochordal remnants. Usually slow growing with an indolent course, most cases are incidental findings on autopsy. Limited data exists on symptomatic patients with EP. Diagnosis mainly relies on correlating histopathologic findings confirming the notochordal elements with MRI. We herein present a middle aged woman with symptomatic EP in the pre-pontine cistern that mimicked an arachnoid cyst on preoperative scans. Additionally, we emphasize the pathological and radiological characteristics of EP that could aid in prompt diagnosis of the lesion with emphasis on considering EP as a differential for mass lesions localized in the pre-pontine cistern.
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Delayed FLAIR-enhancement of benign notochordal remnant (ecchordosis physaliphora).
Neuroradiol J
November 2024
Department of Radiology, AZ Maria Middelares, Ghent, Belgium.
Ecchordosis physaliphora (EP) is a benign notochordal remnant most commonly encountered in the skull base. In opposition to typical cases of its invasive counterpart, that is, chordoma, EP does not show T1-enhancement. Now, we describe three patients with EP, discovered on delayed contrast-enhanced 3D FLAIR performed for endolymphatic hydrops imaging in suspected Menière's disease.
View Article and Find Full Text PDFClinical and Radiologic Follow-Up in Ecchordosis Physaliphora: A Case Series and Literature Review.
World Neurosurg
November 2024
Department of Neurosurgery, Erciyes University School of Medicine, Kayseri, Turkey.
Article Synopsis
- The study aimed to evaluate the clinical and imaging characteristics of ecchordosis physaliphora (EP) in 16 patients, along with a review of existing literature on the condition.* -
- Among the patients, most were middle-aged, with headache and hearing loss being common symptoms; radiologically, EP was characterized by specific MRI features and no enhancement with gadolinium.* -
- The findings highlight the importance of distinguishing EP from chordoma using imaging techniques, as many cases were discovered incidentally and a majority of patients showed good outcomes with conservative management.*
A watch, wait, and rescan approach for incidental benign-appearing notochordal lesions of the skull base.
Neurosurg Focus
May 2024
1Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, Manchester.
Objective: The aim of this study was to describe the natural history of incidental benign-appearing notochordal lesions of the skull base with specific attention to features that can make differentiation from low-grade chordoma more difficult, namely contrast uptake and bone erosion.
Methods: In this retrospective case series, the authors describe the clinical outcomes of 58 patients with incidental benign-appearing notochordal lesions of the clivus, including those with minor radiological features of bone erosion or contrast uptake.
Results: All lesions remained stable during a median follow-up of almost 3 years.
A Rare Case of Benign Long-Standing Ecchordosis Physaliphora.
Cureus
November 2023
Department of Internal Medicine, Taif University, Taif, SAU.
Ecchordosis physaliphora (EP) is a rare benign lesion arising from embryonic notochordal remnants, typically located in the retroclival region. This case report presents a 46-year-old male patient experiencing intermittent headaches and occipital pain. Imaging revealed a well-defined, smoothly corticated bony lesion on the left side of the clivus, accompanied by a characteristic bony stalk devoid of any aggressive features.
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