Inga E. Usher, Evangelos Drosos, Abdalla Morsy, Andrea Wadeson, Roger Laitt, Sarah Abdulla, Aparna Madhavan, Jane Halliday, Scott Rutherford, Andrew T. King, Omar N. Pathmanaban
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A watch, wait, and rescan approach for incidental benign-appearing notochordal lesions of the skull base
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. Thirty-seven (64%) patients underwent contrast-enhanced MRI; lesions in 14 (38%) of these patients exhibited minimal contrast enhancement. Twenty-seven (47%) patients underwent CT; lesions in 6 (22%) of these patients exhibited minimal bone erosion.
CONCLUSIONS
These data make the case for monitoring selected cases of benign-appearing notochordal lesions of the clivus in the first instance even when there is minor contrast uptake or minimal bone erosion.
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