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Supratentorial Ependymoma
Joseph Junewick, MD FACR
over 10 years ago
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Case Detail

Anatomy: Brain
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 11 years ago
Updated: over 11 years ago
Tags: PEDS
Modality/Study Types: MR CT
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15 year old male with difficulty speaking and slowly progressive ataxia.

Case Images


Chordoma (myxoid variant)


CT – well circumscribed low density extra-axial mass containing a single punctate calcification.

MRI – T1 hypointense, T2 hyperintense mass; scattered punctate intralesional enhancement with whispy enhancement emanating from the basisphenoid synchondrosis are present. No osseous destruction or infiltration is demonstrated.

MRS – Absent NAA and choline peaks and elevated lipid and lactate peaks.


Chordomas originate from notochordal remnants and consequently have fairly predictable locations, cranial (32%), spinal (32%), sacral (29%) and other sites. Chordomas can occur at any age but are most commonly seen in the fourth decade of life. Males are twice as likely as females to be affected. They are slow growing tumors with insidious symptoms; intracranial tumors most often present with headache and cranial neuropathy. Most cases are associated extensive osseous destruction.

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