A multilobulated extra-axial midline enhancing mass lesion contacting the clivus, indenting the brainstem and obliterating the pontomedullary cistern. The lesion is moderately heterogeneous, mainly T1 hypointense to brain, with some small foci of T1 hyperintensity and scattered foci of susceptibility. Although the lesion is predominantly T2 hyperintense, it is of lower signal to the adjacent CSF. Despite the indentations of the brainstem "thumb sign", there is no brainstem oedema. No dural tail. The basilar artery is displaced to the left and posteriorly, partially encased by the tumour. Within the limits of MRI, there is possible minor erosion of the clivus. The 4th ventricle is distorted inferiorly. The temporal horns remain dilated, with periventricular FLAIR hyperintensity.
Conclusion: The midline solidly enhancing extra-axial mass lesion in the pontomedullary cistern with internal foci of susceptibility. It is more probably a chordoma than meningioma (with calcification and/or hemorrhage).