Nose and paranasal sinuses: clival chordoma: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: clival chordoma

Sample item

A 45-year-old has headache, diplopia from a sixth nerve palsy and nasal obstruction. CT shows a destructive midline mass of the clivus with internal calcification. Which is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Chordoma

Chordoma arises from notochord remnants along the clivus and sacrum. It is a slow-growing destructive midline tumour that presents with headache and cranial nerve palsies, notably the sixth. Angiofibroma occurs in adolescent males and arises from the sphenopalatine foramen.

Option by option

  • A. Craniopharyngioma

    Craniopharyngioma is suprasellar and presents with visual field loss and endocrine deficits.

  • B. Chordoma (correct)

    Correct. A destructive calcified midline clival mass with an abducens palsy fits a chordoma from notochord remnants.

  • C. Juvenile nasopharyngeal angiofibroma

    Angiofibroma occurs in adolescent boys with epistaxis, arising from the sphenopalatine foramen.

  • D. Nasopharyngeal carcinoma

    Nasopharyngeal carcinoma arises in the fossa of Rosenmuller and presents with a neck node or serous otitis media.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Chordoma. Chordoma arises from notochord remnants along the clivus and sacrum.

Why is "Craniopharyngioma" not the answer?

Craniopharyngioma is suprasellar and presents with visual field loss and endocrine deficits.

Why is "Juvenile nasopharyngeal angiofibroma" not the answer?

Angiofibroma occurs in adolescent boys with epistaxis, arising from the sphenopalatine foramen.

Why is "Nasopharyngeal carcinoma" not the answer?

Nasopharyngeal carcinoma arises in the fossa of Rosenmuller and presents with a neck node or serous otitis media.

What concept does this question test?

It tests Nose and paranasal sinuses: clival chordoma in ENT. It is a slow-growing destructive midline tumour that presents with headache and cranial nerve palsies, notably the sixth. Angiofibroma occurs in adolescent males and arises from the sphenopalatine foramen.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: clival chordoma?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.