Appendix A. Clinical Examples*

Abstract

A 38-year-old woman with a history of double vision due to the paresis of the left N. abducens: a biopsy was performed to confirm the diagnosis of clivus chordoma. Staging with MRI of the craniospinal axis and CT scan of the whole body showed a T4aN0M0 tumor [UICC 8th Edition (Bertero et al., 2017)]. After transsphenoidal partial resection, the patient was presented in the Radiooncology Department for additive irradiation with particle therapy. In the clinical examination, besides the paresis of the N. abducens, a paresis of the N. hypoglossus and the N. glossopharyngeus were found. Headache of moderate intensity was present since surgery. The MRI scan showed residual tumor with contact to the sinus sphenoidalis and the dorsal nasal cavity as well as contact with the prepontine cistern. The tumor surrounds the basilar artery by 360° and has contact with the internal carotid artery and cavum Meckeli. (Figure A.1.1).