Skip to main content

Advertisement

SpringerLink
Log in

A case of paravertebral mediastinal chordoma without bone destruction

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

We report a unique case of mediastinal paravertebral chordoma without bone destruction in a 47-year-old Japanese woman. She was admitted to hospital after a tumor was incidentally detected on a chest radiograph. The tumor was located in the paravertebral region of the mediastinum and did not show any destruction of the thoracic vertebra radiologically. The tumor was clinically diagnosed as a benign neurogenic tumor and the tumor was easily removed surgically. Microscopically, the tumor mainly consisted of tumor cells with extensively vacuolated cytoplasm, arranged in cord- and nest-like fashion against a myxoid matrix background. Immunohistochemically, the tumor cells showed diffuse positivity for pancytokeratin (AE1/AE3) and vimentin. The tumor cell nuclei were positive for brachyury, which is a key transcription factor of notochordal development. These results confirmed the tumor to be an extraosseous chordoma in the paravertebral mediastinal region, which is an extremely rare location for a chordoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Mirra JM, Rocca CD, Nelson SD, Chordoma MF. Tumours of the soft tissue and bone. In: Fletcher CDM, Unni KK, Mertens F, editors. World Health Organization Classification of Tumours. Pathology and genetics. Lyon: IARC Press; 2004. p. 316–7.

    Google Scholar 

  2. Mirra JM. Chordoma. In: Mirra JM, editor. Bone tumors: clinical, radiologic and pathologic correlations. Philadelphia: Lea & Febiger; 1989. p. 648–74.

    Google Scholar 

  3. Unni KK, Inwards CY. Chordoma. In: Unni KK, Inwards CY, editors. Dahlin’s bone tumors. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 248–61.

    Google Scholar 

  4. Cotler HB, Cotler JM, Cohn HE, Israel HI, Gartland JJ. Intrathoracic chordoma presenting as a posterior superior mediastinal tumor. Spine. 1983;8(7):781–6.

    Article  PubMed  CAS  Google Scholar 

  5. Suster S, Moran CA. Chordomas of the mediastinum: clinicopathologic, immunohistochemical, and ultrastructural study of six cases presenting as posterior mediastinal masses. Hum Pathol. 1995;26(12):1354–62.

    Article  PubMed  CAS  Google Scholar 

  6. Wang YP, Lee KS, Chen YJ, Huang JK. Extraosseous chordoma of the retropharyngeal space. Otolaryngol Head Neck Surg. 2004;130(3):383–5.

    Article  PubMed  Google Scholar 

  7. Tirabosco R, Mangham DC, Rosenberg AE, et al. Brachyury expression in extra-axial skeletal and soft tissue chordomas: a marker that distinguishes chordoma from mixed tumor/myoepithelioma/parachordoma in soft tissue. Am J Surg Pathol. 2008;32(4):572–80.

    Article  PubMed  Google Scholar 

  8. Vujovic S, Henderson S, Presneau N, et al. Brachyury, a crucial regulator of notochordal development, is a novel biomarker for chordomas. J Pathol. 2006;209(2):157–65.

    Article  PubMed  CAS  Google Scholar 

  9. Sangoi AR, Dulai MS, Beck AH, Brat DJ, Vogel H. Distinguishing chordoid meningiomas from their histologic mimics: an immunohistochemical evaluation. Am J Surg Pathol. 2009;33(5):669–81.

    Article  PubMed  Google Scholar 

  10. Yamaguchi T, Suzuki S, Ishiiwa H, Shimizu K, Ueda Y. Benign notochordal cell tumors: a comparative histological study of benign notochordal cell tumors, classic chordomas, and notochordal vestiges of fetal intervertebral discs. Am J Surg Pathol. 2004;28(6):756–61.

    Article  PubMed  Google Scholar 

  11. Mirra JM, Brien EW. Giant notochordal hamartoma of intraosseous origin: a newly reported benign entity to be distinguished from chordoma. Report of two cases. Skeletal Radiol. 2001;30(12):698–709.

    Article  PubMed  CAS  Google Scholar 

  12. Kyriakos M, Totty WG, Lenke LG. Giant vertebral notochordal rest: a lesion distinct from chordoma: discussion of an evolving concept. Am J Surg Pathol. 2003;27(3):396–406.

    Article  PubMed  Google Scholar 

  13. Yamaguchi T, Yamato M, Saotome K. First histologically confirmed case of a classic chordoma arising in a precursor benign notochordal lesion: differential diagnosis of benign and malignant notochordal lesions. Skeletal Radiol. 2002;31(7):413–8.

    Article  PubMed  Google Scholar 

  14. Yamaguchi T, Watanabe-Ishiiwa H, Suzuki S, Igarashi Y, Ueda Y. Incipient chordoma: a report of two cases of early-stage chordoma arising from benign notochordal cell tumors. Mod Pathol. 2005;18(7):1005–10.

    Article  PubMed  Google Scholar 

  15. O’Donnell P, Tirabosco R, Vujovic S, et al. Diagnosing and extra-axial chordoma of the proximal tibia with the help of brachyury, a molecule required for notochordal differentiation. Skeletal Radiol. 2007;36(1):59–65.

    Article  PubMed  Google Scholar 

  16. Nielsen GP, Mangham DC, Grimer RJ, Rosenberg AE. Chordoma periphericum: a case report. Am J Surg Pathol. 2001;25(2):263–7.

    Article  PubMed  CAS  Google Scholar 

  17. Herzog G. Chordome. In: Rössle R, editor. Handbuch der speziellen pathologischen Anatomie und Histologie. Bd. IX/5. Berlin: Springer; 1944. p. 380–98.

    Google Scholar 

Download references

Conflict of interest

The authors have no financial relationship with the organization that sponsored the research. The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Jun Matsubayashi, Eiichi Sato & Toshitaka Nagao

  2. Division of Thoracic Surgery, Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Masaharu Nomura, Masatoshi Kakihana, Osamu Uchida, Hisashi Saji & Norihiko Ikeda

  3. Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Jinho Park & Souichi Akata

  4. Department of Pathology and Laboratory Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan

    Tsuyoshi Ishida

Authors
  1. Jun Matsubayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eiichi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masaharu Nomura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masatoshi Kakihana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Osamu Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hisashi Saji
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jinho Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Souichi Akata
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Norihiko Ikeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Toshitaka Nagao
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tsuyoshi Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jun Matsubayashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsubayashi, J., Sato, E., Nomura, M. et al. A case of paravertebral mediastinal chordoma without bone destruction. Skeletal Radiol 41, 1641–1644 (2012). https://doi.org/10.1007/s00256-012-1493-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1493-3

Keywords

Search

Navigation