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Tumor of notochordal tissue remnants

Peak age 20-40 years

Male predominance 2:1

Most common locations:

Sacrum (50%)

Clivus (35%)

Histologically benign but locally invasive.

Often becomes bulky mass with compression of brainstem and cerebellum

Can invade anteriorly into nasopharynx

6th nerve palsy most common clinical presentation.

Imaging:

Frequently develop calcifications

Usually vascular with enhancement

Moderately hypointense on T1, heterogeneously hyperintense on T2.