Total Resection of Clival Chordoma with Brainstem Invasion via Endoscopic Transnasal Approach: Technical Note.

OBJECTIVE

Clival chordomas with brainstem invasion are extremely rare; only 5 cases have been reported in the literature. In such cases total tumor resection is associated with high intraoperative risks and is a notable challenge for the neurosurgeon. However, it is the quality of surgical treatment that influences the future prognosis, despite the efficacy of proton therapy.

METHODS

We describe the clinical case of a 39-year-old male patient with the sudden onset of double vision and left trochlear nerve paresis, who was diagnosed with a clival chordoma with brainstem invasion.

RESULTS

The tumor was successfully resected via unilateral left mononostril endoscopic transnasal approach. The patient had a mild paresis of the left abducens nerve that improved during the postoperative period.

CONCLUSIONS

Clival chordomas with brainstem invasion are extremely rare. In some circumstances, total tumor resection can be achieved.