October 22, 2026
Skull base chordomas are rare, slow-growing bone tumors that develop along the clivus—a dense, central bone structure located at the base of the skull directly in front of the brainstem. Arising from microscopic cellular remnants of the embryonic notochord, chordomas account for less than 1% of all primary brain and skull tumors. Although histologically classified as low-grade or slow-growing, chordomas are clinically aggressive because they invade local bone tissue and expand directly against the brainstem, optic nerves, and internal carotid arteries.
Because clival chordomas grow gradually within the bone structure before expanding into open skull base spaces, early symptoms develop subtly:
Removing a chordoma from the center of the skull base historically required complex open craniotomies that involved moving facial bones or retracting healthy brain tissue. Today, advancements in minimally invasive skull base surgery have altered this treatment path.
Through the Endoscopic Endonasal Approach (EEA), a neurosurgeon works in tandem with an ENT skull base specialist to reach the clivus through the natural nasal passages:
Because chordoma cells routinely infiltrate surrounding bone channels at a microscopic level, achieving a complete cure through surgery alone can be difficult. Following maximal safe surgical resection, patients undergo targeted Proton Beam Therapy. Proton radiation delivers high-dose energy directly to the surgical site while stopping sharply at the tumor boundary, protecting adjacent brainstem and optic pathways.