Case 25 Answer

This could be difficult from just the 1 slice, but there is a destructive lesion involving the clivus.  Although mets could yield a picture, given that it appears centered in the clivus, the knee jerk answer is correct: Clival Chordoma

Reference: http://radiopaedia.org/articles/chordoma

I think we’ll take a break for the holidays and start back up after the New Year. I would like to wish everyone a happy and safe holiday season.