Clival Chordoma Presenting with Ophthalmoplegia and Frontal Headache: A Radioclinical Case Report

Chordomas are rare, slow-growing, locally aggressive malignant tumors arising from remnants of the notochord, commonly involving the clivus at the skull base. We present a case of a 38-year-old male with a 2-year history of progressive diplopia and ophthalmoplegia, recently worsened by frontal headaches. Imaging revealed a destructive, expansile skull base mass centered on the spheno-occipital synchondrosis, extending to adjacent critical neurovascular structures. Histopathology confirmed the diagnosis of clival chordoma. This case highlights the characteristic radiological features of chordoma and its potential for extensive local invasion.