Turkish Neurosurgery 2013 , Vol 23 , Num 4
A Case of Chordoma Invading Multiple Neuroaxial Bones: Report of Ten Years Follow Up
Ahmet Levent AYDIN1, Mehdi SASANI2, Tunc OKTENOGLU2, hsan SOLAROGLU3, Ali Fahir OZER3
1Istanbul Physical Therapy and Rehabilitation Hospital, Department of Neurosurgery, Istanbul, Turkey
2American Hospital, Department of Neurosurgery, Istanbul, Turkey
3Koc University, Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.5666-11.2 Aim: Chordoma is a rare, slow-growing primary malignant tumor of the axial skeleton, arising from the embryonic cells of primitive notochord. Chordomas may arise at different sites of the vertebral column simultaneously or more probably they may metastasise along the neural axis insidiously. Recurrence despite radical surgery and following adjuvant therapy is possible.

Material and Methods: A 46-year-old female patient presented weakness and numbness of the lower extremities. She was operated for clivus chordoma five years ago at another institute.

Results: First the patient underwent surgery for resection of the tumor at the cervical region. a second surgery was performed to resect tumor on the foramen magnum and at the C1 level. Histologic examination of the removed vertebra confirmed the diagnosis of chordoma involving the vertebral body. Radiotherapy was administered after the second surgery. Follow-up neurological and radiological examinations revealed no abnormal neurological symptoms 2,5 years after second surgery. There were no distant organ metastases.

ConclusIon: A patient with diagnosed chordoma of the spine must be investigated with MRI of other regions of the neuraxis to exclude second or even third source of chordoma metastases. In metastatic chordoma cases, radical or gross total resection should be performed for each lesion but if complete surgical resections are impossible, preoperative or postoperative radiation therapy should be planned to improve life expectancy. Keywords : Chordoma, Cervical tumor, Thoracal tumor, Spinal tumor, Metastasis

Corresponding author : Mehdi Sasan, sasanim@gmail.com