Sudden death due to subarachnoid bleeding from ecchordosis physaliphora

Ecchordosis physaliphora (EP) is a rare intracranial mass derived from ectopic notochordal tissue. It is usually a fortuitous finding at autopsy or by computed tomography/magnetic resonance imaging. Very few authors have described an EP-associated symptomatology. In this study, we report a case of the sudden and unexpected death of a 48-year-old woman. At autopsy, the cause of death was subarachnoid bleeding, the origin of which was identified as a gelatinous mass stemming from the dura mater and occupying the prepontine space. Further histological and immunohistochemical investigations allowed the diagnosis of EP.