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Endoscopic Resection of Clival Chordoma: A Tertiary Care Experience

  • Gifty Zacharias
  • Khageswar RoutEmail author
  • Swatee Dash
Original Article
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Abstract

The primary management of the rare tumor chordoma is always surgical. This study indicates the advantage of endoscopic approach for clival chordoma resection. This is a Retrospective case series of 7 endoscopically operated clival chordoma patients between May 2015 and April 2018 in our tertiary care hospital. 5 patients presented with primary disease and 2 were recurrent disease cases. Endoscopic endonasal transphenoidal approach with wide clearance of margins of tumor were performed in all 7 cases. High energy photon radiotherapy were delivered to all. All patients with primary disease as well as recurrent disease had no evidence of disease 24–32 months post surgery. Endoscopic endonasal transphenoidal approach for clival chordoma provides a safe and reliable tumor resection. This less invasive surgery can be considered as an alternative to traditional surgical technique with reduced morbidity. This approach represents a combination of various endoscopic surgical techniques which are minimally invasive and can be applied to ventral skull base surgery.

Keywords

Chordoma Clivus Endoscopic excision Endonasal transphenoidal approach 
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Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The ethical clearance is approved by Institutional Ethical Committee, KIMS Hospital, Bhubaneswar (KIIT/KIMS/IEC/28/2015).

References

  1. 1.
    Horwitz T (1941) Chordal ectopia and its possible relationship to chordoma. Arch Pathol 31:354–362Google Scholar
  2. 2.
    Jaffe HL (1958) Tumors and tumorous conditions of the bones and joints. Lea and Febiger, PhiladelphiaGoogle Scholar
  3. 3.
    Firooznia H, Pinto RS, Lin JP, Baruch HH, Zausner J (1976) Chordoma: radiologic evaluation of 20 cases. Am J Roentgenol 127:797–805CrossRefGoogle Scholar
  4. 4.
    Erdem E, Angtuaco E, Hemert R et al (2003) Comprehensive review of intracranial chordoma. Radiographics 23:995–1009CrossRefGoogle Scholar
  5. 5.
    Shah S, Gandhi R, Brahmbahtt H, Viswakarma R (2015) Surgical excision of clivus chordoma with the use of coblator—a case report. Int J Otolaryngol Head Neck Surg 4:211–214.  https://doi.org/10.4236/ijohns.2015.43035 CrossRefGoogle Scholar
  6. 6.
    Fischbein NJ, Kaplan MJ, Holliday RA, Dillon WP (2000) Recurrence of clival chordoma along the surgical pathway. Am J Neuroradiol 21:578–583PubMedGoogle Scholar
  7. 7.
    Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57(1):43–66CrossRefGoogle Scholar
  8. 8.
    Chugh R, Tawbi H, Lucas DR, Biermann JS, Schuetze SM, Baker LH (2007) Chordoma: the nonsarcoma primary bone tumor. Oncologist 12(11):1344–1350.  https://doi.org/10.1634/theoncologist.12-11-13441 CrossRefPubMedGoogle Scholar
  9. 9.
    Galdstone HB, Bailet JW, Rowland JP (1998) Chordoma of the oropharynx: unusual presentation and review of the literature. Otolaryngol Head Neck Surg 118:104CrossRefGoogle Scholar
  10. 10.
    Boriani S, Bandiera S, Biagini R, Bacchini P, Boriani L, Cappuccio M, Chevalley F, Gasbarrini A, Picci P, Weinstein JN (2006) Chordoma of the mobile spine: fifty years of experience. Spine 31(4):493–503CrossRefGoogle Scholar
  11. 11.
    Tzortzidis F, Elahi F, Wright D, Natarajan SK, Sekhar LN (2006) Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chordomas. Neurosurgery 59(2):230–237.  https://doi.org/10.1227/01.NEU.0000223441.51012.9D CrossRefPubMedGoogle Scholar
  12. 12.
    Baratti D, Gronchi A, Pennacchioli A, Lozza L, Colecchia M, Fiore M, Santinami M (2003) Chordoma: natural history and results in 28 patients treated at a single institution. Ann Surg Oncol 10(3):291–296.  https://doi.org/10.1245/ASO.2003.06.002 CrossRefPubMedGoogle Scholar
  13. 13.
    Schulz-Ertner D, Nikoghosyan A, Thilmann C, Haberer T, Jäkel O, Karger C, Kraft G, Wannenmacher M, Debus J (2004) Results of carbon ion radiotherapy in 152 patients. Int J Radiat Oncol Biol Phys 58(1):631–640CrossRefGoogle Scholar
  14. 14.
    Friedman I, Harrison DFN, Biid ES (1962) The fine structures of chordoma with particular reference to the physaliphorous cell. J Clin Path 15:116–125CrossRefGoogle Scholar
  15. 15.
    Batsakis JG (1974) Tumors of the head and neck clinical and pathological considerations. Williams and Wilkins, Baltimore, pp 264–268Google Scholar
  16. 16.
    Riva P, Crosti F, Orzan F et al (2003) Mapping of candidate region for chordoma development to 1p36.13 by LOH analysis. Int J Cancer 107(3):493–497CrossRefGoogle Scholar
  17. 17.
    Omerod R (1960) A case of chordoma presenting in the nasopharynx. J Laryngol Otol 74:245–254CrossRefGoogle Scholar
  18. 18.
    Burge AJS (1975) A case of oropharyngeal chordoma. J Laryngol Otol 89:115–119CrossRefGoogle Scholar
  19. 19.
    Mindell ER (1981) Chordoma. J Bone Joint Surg Am 63:501–505CrossRefGoogle Scholar
  20. 20.
    Castro JR, Linstadt DE, Bahary JP et al (1994) Experience in charged particle irradiation of tumors of the skull base. Int J Radiat Oncol Biol Phys 29:647–655CrossRefGoogle Scholar
  21. 21.
    Watkinson JC, Clarke RW (2018) Scott-Brown’s otorhinolaryngology. Head Neck Surg 2:1344–1345Google Scholar
  22. 22.
    Hong Jiang W, Ping Zhao S, Hai Xie Z, Zhang H, Zhang J, Yun Xiao J (2009) Endoscopic resection of chordomas in different clival regions. Acta Oto-Laryngologica 129(1):71–83.  https://doi.org/10.1080/00016480801995404 CrossRefPubMedGoogle Scholar
  23. 23.
    Raffel C, Wright DC, Gutin PH, Wilson CB (1985) Cranial chordomas: clinical presentation and results of operative and radiation therapy in twenty-six patients. Neurosurgery 17(5):703–710CrossRefGoogle Scholar
  24. 24.
    Fagundes M, Hug E, Liebsch N, Daly W, Efird J, Munzenrider J (1995) Radiation therapy for chordomas of the base of skull and cervical spine: Patterns of failure and outcome after relapse. Int J Radiat Oncol Biol Phys. 33(3):579–584CrossRefGoogle Scholar
  25. 25.
    Austin JP, Urie MM, Cardenosa G, Munzenrider JE (1993) Probable causes of recurrence in patients with chordoma and chondrosarcoma of the base of skull and cervical spine. Int J Radiat Oncol Biol Phys 25:439–444CrossRefGoogle Scholar
  26. 26.
    Weber AL, Liebsch NJ, Sanchez R, Sweriduk ST Jr (1994) Chordomas of the skull base: radiologic and clinical evaluation. Neuroimaging Clin N Am 4:515–527PubMedGoogle Scholar
  27. 27.
    Ferrares V, Nuzzo C, Zoccali C, Marandino F et al (2010) Chordoma: clinical characteristics, management and prognosis of a case series of 25 patients. BMC Cancer 10:22.  https://doi.org/10.1186/1471-2407-10-22 CrossRefGoogle Scholar
  28. 28.
    Nicoucar K, Rausch T, Becker M, Dulguerov P (2008) Cervical chordoma with retropharyngeal extension presenting with impaired voiceTumori 94:873–876Google Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Kalinga Institute of Medical SciencesKIIT UniversityBhubaneswarIndia

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