Removal of clival chordoma in an adolescent thorough combned pterional transsylvian and anterior temporal approach.

Extensive and aggressive surgical removal is treatment of choice for patients who have chordomas of the cranial base. Well-developed microsurgical techniques, as well as good surgical judgment learned from experience are essential to avoid major morbidity. A 14-year-old female presented with progressive headaches and diplopia for three months. Cranial magnetic resonance imaging demonstrated a well-circumscribed mass in the clival region. The mass was totally excised via right combined pterional transsylvian and anterior temporal approach (+ orbitozygomatic osteotomy). The tumor was located extradurally. The resected tumor had the typical histological and immunohistochemical characteristics of chordoma. No radiation therapy or chemotherapy was administered.