Multicentric Chordoma – A Case Report and Review of Literature

Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.

BACKGROUND AND IMPORTANCE: Chordomas are relatively rare tumors that arise from the neuraxis. Most often, chordomas are single lesions that metastasize late. There have been very few cases of chordomas arising from multiple foci along the neuraxis. In this paper, we present a case of a multicentric chordoma.

CLINICAL PRESENTATION: The patient presented with pain in her right neck and soreness in her right shoulder for about two and a half years that she attributed to a muscle strain. She experienced worsening of her symptoms, which prompted her to seek medical care. The patient underwent an occiput to C6 posterolateral fusion with autograft as well as an occiput to C6 posterior segmental instrumentation along with decompression of the spinal cord. One month following the initial surgery, the patient underwent a second surgery. The C2 and C3 vertebral bodies were completely resected and a C1-C4 anterior fusion was then carried out. A C5 vertebrectomy and C4-C6 fusion were also performed at this time. The patient then received proton beam radiation to the entire affected area.

CONCLUSION: Recent papers have suggested that chordomas arise from benign notochordal tumors. We suggest that our patient suffered from multicentric chordomas with possible benign notochordal tumors. Although benign notochordal tumors do not require surgical resection, the possibility of transformation to a malignant lesion requires close follow-up.

Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.

Original Page: http://neurosurgerycns.wordpress.com/2011/07/18/ahead-of-print-multicentric-chordoma-a-case-report-and-review-of-literature/