%0 Journal Article
%T A watch, wait, and rescan approach for incidental benign-appearing notochordal lesions of the skull base.
%A Usher IE
%A Drosos E
%A Morsy A
%A Wadeson A
%A Laitt R
%A Abdulla S
%A Madhavan A
%A Halliday J
%A Rutherford S
%A King AT
%A Pathmanaban ON
%J Neurosurg Focus
%V 56
%N 5
%D 2024 05
%M 38691870
%F 4.332
%R 10.3171/2024.2.FOCUS23912
%X 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.<BR>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.<BR>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.<BR>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.