Recurrent Metastatic Chordoma to the Liver: A Case Report and Review of the Literature

Abstract

Chordoma is a rare malignant neoplasm derived from notochordal tissue that primarily affects the axial skeleton. Almost 40% of patients have non-cranial chordoma metastases. The most common metastatic sites are the lungs, bones, lymph nodes, and subcutaneous tissue. We present a 52-year female with a history of sacral chordoma presenting with abdominal fullness, early satiety, and a palpable abdominal mass. Abdominal magnetic resonance imaging (MRI) revealed an isolated, highly vascularized, and multilobed liver mass in the left lateral segment. The mass was surgically removed using a clean surgical margin. A histological examination and immunohistochemical staining were consistent with a metastatic chordoma. Two years later, follow-up imaging studies showed a 6.5 × 4.0 × 2.0 cm right liver lesion with multiple lungs, chest wall, pleural, and diaphragmatic lesions. Microscopic- and immunohistochemical staining revealed a recurrent metastatic chordoma. Herein, we present a unique case of metastatic recurrent chordoma in the liver with the involvement of other sites. To the best of our knowledge, no other case of recurrent liver metastasis has been reported.

Chordoma cancer stem cell subpopulation characterization may guide targeted immunotherapy approaches to reduce disease recurrence

“…Recurrence is deemed the most important factor in patient mortality following diagnosis ( 6 , 9 ). Metastasis results in 3-30% of cases, most often in the context of a recurrent tumor ( 2 , 10 , 11 ). Cancer stem cells have been implicated in resistance to common therapies, recurrence, and metastasis ( 12 – 14 ), and thus, further investigation into this subpopulation may generate new angles from which to mitigate chordoma treatment failure.…”