Collision Tumor of the Clivus: Chordoma and Chronic Lymphocytic Leukemia
Bibliographic record
Abstract
Collision tumors, defined as the simultaneous occurrence of two distinct neoplasms within the same anatomical location, are exceptionally rare in the clivus. The coexistence of chordoma and chronic lymphocytic leukemia (CLL) within the clivus has not been previously reported, making this case particularly noteworthy.We present the case of a 69-year-old woman with a known history of stable CLL who presented with a 3-month history of progressive right-sided horizontal diplopia and hemianopsia. Imaging revealed a large sellar/suprasellar lesion with significant involvement of both cavernous sinuses, prompting surgical intervention. An endoscopic endonasal transsphenoidal and transclival approach was utilized to achieve near-total mass resection, with a small remnant left in the right cavernous sinus due to its proximity to the internal carotid artery. Histopathological examination confirmed the presence of a collision tumor composed of chordoma and CLL.This case represents the first reported instance of a collision tumor involving a chordoma and CLL within the clivus. The patient's postoperative course was uneventful, and she remains stable at 3-month follow-up after receiving adjuvant radiotherapy. The rarity of such a collision tumor underscores the need for heightened clinical suspicion and thorough pathological evaluation in cases presenting with atypical skull base lesions. The involvement of a multidisciplinary team was crucial in the management and favorable outcome of this complex case.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".