Abstract
Study design
Case report.
Purpose
We present a rare case of a giant chordoma in the thoracolumbar spine and review the current literature. We describe its complicated clinical progression, hoping to shed light on the clinical management of this complex tumor.
Methods
We present a previously healthy 41-year-old man who experienced progressive low back pain at T10-L2 for the past 2 years. A giant tumor was detected on magnetic resonance imaging, and aspiration biopsy was used to obtain a definite pathological diagnosis. The postoperative pathology confirmed that it was a chordoma. He underwent complete resection of the tumor and internal fixation of the vertebral bodies, which is a good way to control recurrence and preserve stability.
Results
Histopathology confirmed the tumor was a chordoma via immunohistochemical study of both the biopsy sample and the surgically resected tissues. There has been no recurrence or metastasis at the 30-month postsurgery radiographic examination. The internal fixation has remained stable.
Conclusion
Primary chordoma in the thoracolumbar spine is extremely rare. The treatment is difficult because the current literature is sparse and patients are rare. Complete resection and internal fixation are effective for reducing recurrences and metastasis.
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References
Tuna H, Aydin V, Bozkurt M, Attar A (2005) Chordoma of the lumbar spine: a case report. Neurocirugia 16:169–172
Cheng EY, Ozerdemogulu RA, Transfeldt EE, Thompson RC (1999) Lumbosacral chordoma: prognostic factors and treatment. Spine 24:1639–1645
Ferraresi V, Nuzzo C, Zoccali C et al (2010) Chordoma: clinical characteristics, management and prognosis of a case series of 25 patients. BMC Cancer 10:22
Boriani S, Chevalley F, Weinstein J et al (1996) Chordoma of the spine above the sacrum: treatment and outcome in 21 cases. Spine 21:1569–1577
Vincken P, De Schepper A, Bloem JL (2006) Spinal chordoma of the Dorsolumbar Junction. JBR-BTR 89:160–161
Chadha M, Agarwal A, Wadhwa N (2005) Chondroid chordoma of the L5 spinous process and lamina a case report. Eur Spine J 14:803–806
Chatterjee S, Bodhey NK, Gupta AK, Periakaruppan A (2010) Chordoma of the lumbar spine presenting as sciatica and treated with vertebroplasty. Cardiovasc Intervent Radiol 33:1278–1281
Sivabalan P, Li J, Mobbs RJ (2011) Extensive lumbar chordoma and unique reconstructive approach. Eur Spine J 20(2 Suppl):336–342
Chivukula M, Rao R, Macchi J et al (2002) FNAB cytology of chordoma masquerading as adenocarcinoma: case report. Diagn Cytopathol 26:306–309
Yamaguchi T, Iwata J, Sugihara S et al (2008) Distinguishing benign notochordal cell tumors from vertebral chordoma. Skeletal Radiol 73:291–299
Yamaguchi T, Yamato M, Saotome K (2002) First histologically confirmed case of a classic arising in a precursor benign notochordal lesion: differential diagnosis of benign and malignant notochordal lesions. Skelet Radiol 31:413–418
Nishiguchi T, Mochizuki K, Tsujio T et al (2010) Lumbar vertebral chordoma arising from an intraosseous benign notochordal tumour: radiological findings and histopathological description with a good clinical outcome. Br J Radiol 83:49–53
Yamaguchi T, Suzuki S, Ishiiwa H, Ueda Y (2004) Intraosseous benign notochordal cell tumours: overlooked precursors of classic chordomas? Histopathology 44:597–602
Boriani S, Bandiera S, Biagini R et al (2006) Chordoma of the mobile spine: fifty years of experience. Spine 31:493–503
Delank KS, Kriegsmann J, Drees P et al (2002) Metastasizing chordoma of the lumbar spine. Eur Spine J 11:167–171
Park L, DeLaney TF, Liebsch NJ et al (2006) Sacral chordomas: impact of high dose proton/photon-beam radiation therapy combined with or without surgery for primary versus recurrent tumor. Int J Radiat Oncol Biol Phys 65:1514–1521
Rutz HP, Weber DC, Sugahara S et al (2007) Extracranial chordoma: outcome in patients treated with function-preserving surgery followed by spot scanning proton beam radiation. Int J Radiat Oncol Biol Phys 67:512–520
Rhomberg W, Eiter H, Bohler F, Dertinger S (2006) Combined radiotherapy and razoxane in the treatment of chondrosarcomas and chordomas. Anticancer Res 26:2407–2412
Casali PG, Messina A, Stacchiotti S et al (2004) Imatinib mesylate in chordoma. Cancer 101:2086–2097
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Pu, F., Wang, B., Liu, J. et al. Giant chordoma in the thoracolumbar spine: a case report and literature review. Eur Spine J 26 (Suppl 1), 95–99 (2017). https://doi.org/10.1007/s00586-016-4877-6
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DOI: https://doi.org/10.1007/s00586-016-4877-6