Recurrent chordoma of the palate occurring in the surgical pathway: A case report

Tumour seeding in the surgical pathway after resection of skull base chordoma

“…However, from the available series, we found a mean incidence of surgical pathway recurrence of 2.7%. This data is quite similar to that reported in the previous literature review published by Iloreta et al 19 In all the published series, [9][10][11][12][13][14][15][16][17][18][19][20][21] patients underwent open surgery, mainly by anterior approaches through transnasal/trans-sphenoidal or transoral pathways, that could be considered procedures of higher risk.…”

“…From literature search, we found 6 retrospective series and 7 case reports of patients who experienced surgical pathway recurrence after excision of skull base chordomas [9][10][11][12][13][14][15][16][17][18][19][20][21] (Table 1). No prospective trials were found.…”

“…19,28 From the available data of the largest series and the case reports, 9-21 the postoperative radiation volume did not include, in principle, the surgical path and the site of surgical seeding was found outside the radiation fields or in the low dose volumes. Some authors suggested the inclusion of biopsy and surgical pathways in the radiotherapy field in order to reduce the risk of recurrence 12,14 but the inclusion of the entire surgical access path in radiation therapy field still remains a controversial issue as suggested by the recent consensus meeting because of the risk of toxicity related to treating a large target volume to high radiation dose 8 considering the low occurrence rate of surgical seeding that ranges from 1.3% to 7.3% in the reported series. In this regard, multidisciplinary discussion could be helpful to identify those cases at higher risk of tumour seeding due to tumour location and complexity of the surgical procedure.…”

Spontaneous Debulking of Middle Fossa Chordoma Extension after Transnasal Petroclival Biopsy – Report of a Case

“…Only 8 cases of seeding of chordomas in the surgical pathway have been reported in the world literature. This is a rare occurrence [ 6 ] . In our case, the intent of the initial surgery was to provide only a biopsy due to the patient's wishes.…”

Surgical Pathway Seeding of Clivo-Cervical Chordomas

“…In general 1-4 these neoplasms behave aggressively and are associated with a high local recurrence rate, up to 21 to 29%, as well as the potential to metastasize. 1,2,5 Factors that can be associated with local recurrence include low postoperative radiation doses and large tumor bulk. 1 The most common site of distant metastases are the lungs (58%), lymph nodes (33%), liver (22%), bone (17%), and skeletal muscle (9%).…”