Spontaneous regression of a clival chordoma. Case report
Abstract
In this case report, we present a rare and previously unreported case of spontaneous regression of a histologically consistent clival chordoma. At the time of diagnosis, imaging demonstrated a T2 hyperintense and T1 isointense midline skull base mass, centered in the nasopharynx, with scalloping of the ventral clivus consistent with a chordoma measuring 3.1 × 1.9 × 3.0 cm (8.84 cm3). On pre-operative imaging 2 months later, with no intervening therapy, the mass had regressed by 61.7% to a size of 2.3 × 2.1 × 1.4 cm (3.38 cm3). The patient self-administered several herbal supplements and animal oils which may have contributed to tumor regression. The purpose of this report is to document this rare occurrence and provide a comprehensive description of the case details and list of the various medications, herbs, and supplements used prior to this rare event.
Keywords
Chordoma Spontaneous RegressionNotes
Compliance with ethical standards
The patient has consented to the submission of the case report for publication.
References
- 1.Azzarelli A, Quagliuolo V, Cerasoli S, Zucali R, Bignami P, Mazzaferro V, Dossena G, Gennari L (1988) Chordoma: natural history and treatment results in 33 cases. J Surg Oncol 37(3):185–191CrossRefGoogle Scholar
- 2.Ban TA (2006) The role of serendipity in drug discovery. Dialogues Clin Neurosci 8(3):335–344PubMedPubMedCentralGoogle Scholar
- 3.Boari N, Gagliardi F, Cavalli A, Gemma M, Ferrari L, Riva P, Mortini P (2016) Skull base chordomas: clinical outcome in a consecutive series of 45 patients with long-term follow-up and evaluation of clinical and biological prognostic factors. J Neurosurg 125(2):450–460CrossRefGoogle Scholar
- 4.Coley WB (1991) The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. 1893. Clin Orthop (262):3–11Google Scholar
- 5.Di Maio S, Temkin N, Ramanathan D, Sekhar LN (2011) Current comprehensive management of cranial base chordomas: 10-year meta-analysis of observational studies. J Neurosurg 115(6):1094–1105CrossRefGoogle Scholar
- 6.Erdem E, Angtuaco EC, Van Hemert R, Park JS, Al-Mefty O (2003) Comprehensive review of intracranial chordoma. RadioGraphics 23(4):995–1009CrossRefGoogle Scholar
- 7.Heffelfinger MJ, Dahlin DC, MacCarty CS, Beabout JW (1973) Chordomas and cartilaginous tumors at the skull base. Cancer 32(2):410–420CrossRefGoogle Scholar
- 8.Kitai R, Yoshida K, Kubota T, Sato K, Handa Y, Kasahara K, Nakajima H (2005) Clival chordoma manifesting as nasal bleeding. A case report. Neuroradiology 47(5):368–371CrossRefGoogle Scholar
- 9.Lagman C, Varshneya K, Sarmiento JM, Turtz AR, Chitale RV Proposed diagnostic criteria, classification schema, and review of literature of notochord-derived ecchordosis physaliphora. Cureus. https://doi.org/10.7759/cureus.547
- 10.McMaster ML, Goldstein AM, Bromley CM, Ishibe N, Parry DM (2001) Chordoma: incidence and survival patterns in the United States, 1973-1995. Cancer Causes Control CCC 12(1):1–11CrossRefGoogle Scholar
- 11.Meng T, Jin J, Jiang C, Huang R, Yin H, Song D, Cheng L (2019) Molecular targeted therapy in the treatment of chordoma: a systematic review. Front Oncol 9:30CrossRefGoogle Scholar
- 12.Mobley BC, McKenney JK, Bangs CD et al (2010) Loss of SMARCB1/INI1 expression in poorly differentiated chordomas. Acta Neuropathol (Berl) 120(6):745–753CrossRefGoogle Scholar
- 13.Moore KA, Bohnstedt BN, Shah SU, Abdulkader MM, Bonnin JM, Ackerman LL, Shaikh KA, Kralik SF, Shah MV (2015) Intracranial chordoma presenting as acute hemorrhage in a child: case report and literature review. Surg Neurol Int. https://doi.org/10.4103/2152-7806.155445 CrossRefGoogle Scholar
- 14.Nishiguchi T, Mochizuki K, Ohsawa M, Inoue T, Kageyama K, Suzuki A, Takami T, Miki Y (2011) Differentiating benign notochordal cell tumors from chordomas: radiographic features on MRI, CT, and tomography. Am J Roentgenol 196(3):644–650CrossRefGoogle Scholar
- 15.Radl R, Leithner A, Kastner N, Bodo K, Nader A, Windhager R (2005) Disappearance of a cervical spine chordoma after nonoperative treatment. A case report. J Bone Joint Surg Am 87(8):1822–1827CrossRefGoogle Scholar
- 16.Walcott BP, Nahed BV, Mohyeldin A, Coumans J-V, Kahle KT, Ferreira MJ (2012) Chordoma: current concepts, management, and future directions. Lancet Oncol 13(2):e69–e76CrossRefGoogle Scholar
- 17.Zou Y, Neale N, Sun J et al (2018) Prognostic factors in clival chordomas: an integrated analysis of 347 patients. World Neurosurg 118:e375–e387CrossRefGoogle Scholar