Chordoma presenting as a posterior mediastinal mass in a pediatric patient

Ahrendt, Mark; Wesselhoeft, Conrad

doi:10.1016/0022-3468(92)90489-t

Cited by 21 publications

(7 citation statements)

References 15 publications

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“…An intrathoracic chordoma manifesting as a posterior mediastinal tumor is rare. Only nine cases have been reported [2][3][4] in English-language publications to date. We report the 1 0th case and, to our knowledge, the first description of the MR imaging appearance of this entity.…”

Section: Chordomasmentioning

confidence: 99%

Posterior mediastinal chordoma: MR imaging findings.

Taki

Kakuda²,

Kakuma³

et al. 1996

American Journal of Roentgenology

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Section: Chordomasmentioning

confidence: 99%

Posterior mediastinal chordoma: MR imaging findings.

Taki

Kakuda²,

Kakuma³

et al. 1996

American Journal of Roentgenology

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“…The initial symptoms of thoracic chordoma are subtle and nonspecific. Usually, symptoms are seen with spinal cord compression or thoracic viscera compression (1,9,11,15). The second tumor of our case was at the thoracal region, T3 level.…”

Section: Discussionmentioning

confidence: 67%

A case of chordoma invading multiple neuroaxial bones:report of ten years follow up

Aydın¹,

Sasani²,

Öktenoğlu³

et al. 2012

Turkish Neurosurgery

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AIm: Chordoma is a rare, slow-growing primary malignant tumor of the axial skeleton, arising from the embryonic cells of primitive notochord. Chordomas may arise at different sites of the vertebral column simultaneously or more probably they may metastasise along the neural axis insidiously. Recurrence despite radical surgery and following adjuvant therapy is possible. mAterIAl and methOds:A 46-year-old female patient presented weakness and numbness of the lower extremities. She was operated for clivus chordoma five years ago at another institute.results: First the patient underwent surgery for resection of the tumor at the cervical region. a second surgery was performed to resect tumor on the foramen magnum and at the C1 level. Histologic examination of the removed vertebra confirmed the diagnosis of chordoma involving the vertebral body. Radiotherapy was administered after the second surgery. Follow-up neurological and radiological examinations revealed no abnormal neurological symptoms 2,5 years after second surgery. There were no distant organ metastases.COnClusIOn: A patient with diagnosed chordoma of the spine must be investigated with MRI of other regions of the neuraxis to exclude second or even third source of chordoma metastases. In metastatic chordoma cases, radical or gross total resection should be performed for each lesion but if complete surgical resections are impossible, preoperative or postoperative radiation therapy should be planned to improve life expectancy.KeywOrds: Chordoma, Cervical tumor, Thoracal tumor, Spinal tumor, Metastasis ÖZ AmAÇ: Kordoma, omurganın ender rastlanan, yavaş ilerleyen malign karakterli bir tümörüdür. Primitif notokordun embryo hücrelerinden köken alır. Omurganın farklı bölgelerinde, birbirinden bağımsız kordoma odakları eş zamanlı olarak gelişmeye başlayabilir. Fakat daha sıklıkla, birinci tümör odağından kaynaklanan metastatik kordoma lezyonları tüm nöral aks boyunca yayılabilir. Radikal cerrahiye ve ek onkolojik tedaviye rağmen rekürens sık görülür. yÖntem ve GereÇler: Bu sunumda tartışılan 46 yaşındaki kadın hasta, bacaklarında kuvvet ve his kaybı şikayetiyle kliniğimize başvurmuştur. Hasta, beş yıl önce, ayrı bir merkezde klivus kordoması tanısıyla opere edilmiştir.BulGulAr: Hasta öncelikle servikal bölgedeki tümör için opere edilmiştir. İkinci seansta foramen magnum ve C1 seviyesindeki tümör çıkarılmıştır. Patolojik inceleme sonucunda, omurga cismini tutan kordoma lezyonu tanısı konmuştur. İkinci cerrahi seansından sonra hasta radyoterapiye yönlendirilmiştir. Bu tedaviden ikibuçuk yıl sonra yapılan değerlendirmede, hastanın nörolojik muayenesinde progresyon gözlenmemiştir.sOnuÇ: Omurganın herhangi bir lokalizasyonunda kordoma tanısı konulan bir hastada, tüm spinal bölge manyetik rezonans görüntüleme (MRG) tetkiki ile incelenmelidir. Bu hastalarda birden fazla kordoma odağına rastlanabilir. Birden fazla odak tespit edilmesi durumunda, her ayrı tümör odağı için rezeksiyon planlanmalıdır. Total rezeksiyonun mümkün olmaması durumunda, yaşam süresini uzatmak...

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“…Nevertheless, it appears that despite the earlier age of symptom onset, thoracic spine chordomas are not more aggressive than other chordomas. Data from the two largest series indicate survival rates between 50 and 60% at 5-year follow-up after surgical resection and radiation therapy [2,3,9]. Metastatic disease occurs in 5-10% of all chordomas but is rarely present at the time of diagnosis [2,6].…”

Section: Discussionmentioning

confidence: 99%

Chordoma of the thoracic spine in an 89-year-old

Fontes

O’Toole

2011

Eur Spine J

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Study design Case report and literature review. Objective Report the highly unusual presentation of thoracic spine chordoma in an 89-year-old and review existing literature as it impacts treatment in the elderly. Summary of background data Chordomas are infrequent tumors of the spine that commonly present during midadulthood at the spheno-occipital or sacrococcygeal junctions. The mobile spine is affected in 10-15% of cases but chordomas are extremely rare in the thoracic spine. Chordoma rarely enters the differential diagnosis of spinal tumors in elderly patients, for whom metastases and multiple myeloma are by far the most common. Methods A case report is detailed of an 89-year-old male presenting with incapacitating pain and early signs of thoracic myelopathy. A lytic, expanding lesion of the T10 vertebral body with epidural spinal cord compression was identified. In the absence of evidence of other primary tumor, a CT-guided needle biopsy revealed chordoma. A literature review of reported thoracic spine chordomas was also performed. Results An intralesional posterolateral resection and reconstruction was performed with good results and no recurrence at 13 months' follow-up. 30 reports of thoracic spine chordomas were identified in the literature since 1902. Mean age of presentation at 35.7 years is earlier than for most chordomas. The oldest previously reported patient was 68-year-old. Neurological impairment at presentation is rare with the usual presenting symptom being pain.Response to radiation and chemotherapy is limited. 5-year survival rates range from 50 to 60%. Conclusion Chordoma is a highly uncommon epidural neoplasm of the thoracic spine and is vanishingly rare in elderly patients. This report documents the oldest reported patient with thoracic spine chordoma at 89-year-old. Their locally aggressive behavior typically prompts consideration of aggressive surgical resection. When tailored to the individual patient, such procedures are feasible without excessive morbidity even in elderly patients.

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Chordoma presenting as a posterior mediastinal mass in a pediatric patient

Cited by 21 publications

References 15 publications

Posterior mediastinal chordoma: MR imaging findings.

Posterior mediastinal chordoma: MR imaging findings.

A case of chordoma invading multiple neuroaxial bones:report of ten years follow up

Chordoma of the thoracic spine in an 89-year-old

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