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^1,2,3Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Neurosurgery, İstanbul, Turkey
^4,5İstanbul University, Medicine Faculty of İstanbul, Neuropathology, İstanbul, Turkey Extensive and aggressive surgical removal is treatment of choice for patients who have chordomas of the cranial base. Well-developed micro s u rgical techniques, as well as good surgical judgment learned from experience are essential to avoid major morbidity. A 14-year-old female presented with pro g ressive headaches and diplopia for three months. Cranial magnetic resonance imaging demonstrated a well-circumscribed mass in the clival region. The mass was totally excised via right combined pterional transsylvian and anterior temporal approach (+ orbitozygomatic osteotomy). The tumor was located extradurally. The resected tumor had the typical histological and immunohistochemical characteristics of chordoma. No radiation therapy or chemotherapy was administered. Keywords : Chordoma, Clivus, Combined approach, Transsylvian approach, Anterior temporal approach