A case of ecchordosis physaliphora presenting with an abducens nerve palsy: A rare symptomatic case managed with endoscopic endonasal transsphenoidal surgery

BACKGROUND: Ecchordosis physaliphora (EP) is a benign notochordal remnant that is usually asymptomatic; symptomatic cases are extremely rare. Most of the reported symptomatic cases were managed by resection via craniotomy. CASE DESCRIPTION: We report a case of a 20-year-old male presenting with abducens nerve palsy. Magnetic resonance imaging performed on admission demonstrated a mass in the retroclival prepontine location. The patient was treated successfully by endoscopic endonasal trans-sphenoidal surgery (ETSS), his postoperative course was uneventful, and the abducens nerve palsy disappeared. CONCLUSION: ETSS has advantages not only for treatment but also for differentiation between EP and intradural chordoma. This is the first case of symptomatic EP successfully treated solely by ETSS.