The CT guided transoral approach: A biopsy technique for a poorly differentiated chordoma in a 5 year old


  • Robert Michael D'Ortenzio
  • Stefano Tolhurst
  • Melissa Harvey
  • Ravi Ghag
  • Manraj K.S. Heran



Poorly differentiated chordoma, pediatric, spine, CT guided, transoral


Mass lesions presenting at the craniocervical junction often present a unique challenge due to the complex anatomic arrangement limiting access for tissue diagnosis. The transoral approach has predominantly been used for percutaneous vertebroplasty of high cervical vertebrae with limited literature describing image guided biopsy for bony lesions in this region in the pediatric patient. We describe a technique of computed tomography guided transoral biopsy of a poorly differentiated chordoma located at the C1-C2 level in a 5-year-old child, and review this diagnosis.

Author Biographies

Robert Michael D'Ortenzio

Radiology Resident physician

Department of Radiology, Vancouver General Hospital

Stefano Tolhurst

Radiology Fellow 

Department of Radiology, Vancouver General Hospital

Melissa Harvey

Associate Professor

Department of Pediatrics, BC Childrens Hosital

Ravi Ghag

Associate Professor,

Department of Orthopaedics, BC Children's Hospital

Manraj K.S. Heran

Associate Professor

Department of Radiology, BC Children's Hospital






Interventional Radiology