Endoscopic endonasal transclival resection of a “pontine chordoma”: Technical case report

Clival chordomas represent very challenging neoplasms, due to their tendency to infiltrate bone, frequent recurrence, involvement of important neurovascular structures, and deep location. Lesions involving the brainstem remain difficult to access through conventional skull-base approaches which are often associated with significant morbidities. We present a successful purely endoscopic endonasal transclival resection of a rare chordoma located in the ventromedial pons. Recent advances in endoscopic technology make endoscopic endonasal approach (EEA) a possible alternative to the treatment of ventral brainstem lesions. •Brainstem invasion is an extremely rare manifestation of clival chordoma.•To the best of our knowledge, this is the first reported successful utilization of such an approach to resect a “pontine chordoma”.•Recent advances in endoscopic technology make endoscopic endonasal approach a possible alternative to the treatment of ventral brainstem lesions.