Sacrococcygeal chordoma: MR imaging in 30 patients

Sung, Mi Sook; Lee, Gyung Kyu; Kang, Heung Sik; Kwon, Soon Tae; Park, Jin Gyoon; Suh, Jin Suck; Cho, Gil Ho; Lee, Sung Moon; Chung, Myung Hee; Resnick, Donald

doi:10.1007/s00256-004-0840-4

Cited by 81 publications

(32 citation statements)

References 27 publications

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“…Chordomas, in contrast, typically present as midline aggressive osteolytic destructive lesions with associated cortical destruction, soft tissue mass and may contain internal matrix calcification [4, 12]. The majority of chordomas also demonstrate increased activity on Tc 99-m nuclear scintigrams [13] and typically enhance with gadolinium [14]. An additional imaging feature that can be instrumental in differentiating between BNCT and chordoma is the presence of tiny foci of intralesional fat.…”

Section: Discussionmentioning

confidence: 99%

Benign Notochordal Cell Tumor of the Sacrum with Atypical Imaging Features: The Value of CT Guided Biopsy for Diagnosis

Pasalic¹,

Luetmer²,

Hunt³

et al. 2013

TONIJ

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We report a case of a benign notochordal cell tumor (BNCT) of the sacrum with atypical imaging features, which was incidentally discovered in a 74-year-old man undergoing evaluation for progressively worsening hip and back pain. It is important for radiologists, pathologists and orthopedic surgeons to be aware of the diagnosis of BNCT and be familiar with its radiographic features to avoid unnecessary treatment. This case illustrates the advantage of percutaneous computed tomography (CT)-guided biopsy as a minimally invasive technique for definitive diagnosis of a BNCT with atypical imaging features.

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Section: Discussionmentioning

confidence: 99%

Benign Notochordal Cell Tumor of the Sacrum with Atypical Imaging Features: The Value of CT Guided Biopsy for Diagnosis

Pasalic¹,

Luetmer²,

Hunt³

et al. 2013

TONIJ

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“…Although it is possible to have an adequate demonstration of the bulk of the tumor, the appearance of localized growth could be misleading and soft tissue invasion is often missed in a detailed use of CT for chordoma (12). Contrast-enhanced MRI is the gold standard when it comes to radiological tools (16). It offers several potential advantages in the evaluation of sacrococcygeal chordomas (11,17).…”

Section: Discussionmentioning

confidence: 99%

Total resection of inferiorly located sacral chordoma with posterior only approach: case report and review of the literature

Sabuncuoğlu

Özdoğan²,

Doğan³

et al. 2009

Turkish Neurosurgery

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Chordoma is a primary sacral neoplasm of ectodermal origin and makes up %1-4 of all primary bone tumors. It is usually present on the midline cerebrospinal axis and the most common locations are the spheno-clival region and the sacrum. The treatment of primary sacral tumors represents a challenge because of a large tumor mass at presentation and a hemorrhage risk in surgery. Sacral tumors may present a difficult problem to the surgeon who desires to obtain a clear margin of excision. Using the retrorectal fat tissue as a cleavage line in the posterior approach guides the neurosurgeon to resect the tumor totally and reduce the hemorrhage in sacral chordomas. In this case report, we tried to discuss the advantages of using of retrorectal fat tissue as a cleavage line in sacral chordomas under the literature. KeywoRdS: Sacrum, Posterior approach, Retrorectal fatty tissue ÖZ Kordoma ektodermal kaynaklı primer sakral neoplazmdır ve tüm primer kemik tümörlerinin %1-4'ünü oluşturur. Genellikle serebrospinal aksın orta hattında bulunurlar ve çoğunlukla yerleşim yerleri sfenoklival bölge ve sakrumdur. Primer sakral tümörlerin tedavisi; ilk ortaya çıktıklarında büyük bir kitle oluşturmuş olmaları ve cerrahide kanama riskleri nedeniyle çözülmesi gereken bir sorun olarak durmaktadır. Sakral tümörler, net bir eksizyon sınırı sağlamak isteyen cerrahlar için zorlu bir problem oluşturur. Posterior yaklaşımda retrorektal yağ dokusunun klavaj hattı olarak kullanılması; beyin cerrahına tümörün tümüyle rezeke edilmesi için yol gösterir ve sakral kordomalarda kanamayı azaltır. Bu olgu sunumunda, sakral kordomalarda retrorektal yağ dokusunun klavaj hattı olarak kullanılmasının yararlarını literatür eşliğinde tartışmak istedik.

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“…Currently, conventional MRI is the gold standard for the primary assessment of chordoma because it allows for the discrimination of tumor soft tissue from normal architecture, as well as the surveillance of spinal metastases (5–7). Classically, chordomas appear isointense or hypointense on T1-weighted MRI and hyperintense on T2-weighted MRI (8).…”

Section: Introductionmentioning

confidence: 99%

T1-Weighted Dynamic Contrast-Enhanced MR Perfusion Imaging Characterizes Tumor Response to Radiation Therapy in Chordoma

Santos¹,

Peck²,

Arévalo-Pérez³

et al. 2017

AJNR Am J Neuroradiol

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Background and Purpose Chordomas notoriously demonstrate a paucity of changes following radiation therapy on conventional MRI. We hypothesize that dynamic contrast enhanced (DCE) MR perfusion imaging parameters of chordomas would change significantly following radiation therapy. Materials and Methods Eleven pathology-proven chordoma patients who completed DCE MR perfusion imaging pre -and post-radiation therapy were enrolled. Quantitative tumor measurements were taken by two attending neuroradiologists. ROIs were used to calculate vascular permeability (Ktrans) and plasma volume (Vp), and generate dynamic contrast enhancement curves. Quantitative analysis was performed to determine mean and maximum Vp and Ktrans values, while semi-quantitative analysis on averaged concentration curves was used to determine the area under the curve (AUC). A Mann-Whitney U test at a significance level of p<0.05 was used to assess differences of above parameters between pre- and post-radiation therapy. Results Vp mean (pre-treatment μ=0.82, post-treatment μ=0.42), Vp maximum (pre- treatment μ=3.56; post- treatment μ=2.27), and Ktrans mean (pre- treatment μ=0.046; post- treatment μ=0.028) in the ROIs significantly decreased after radiation therapy (p<0.05), thereby demonstrating potential for assessing tumor response. AUC values also demonstrated significant differnces (p<0.05). Conclusions Vp and Ktrans, decreased after radiation therapy, suggesting that these DCE-MR perfusion parameters may be useful for monitoring chordoma growth and response to radiation therapy. Additionally, the characteristic dynamic MR signal intensity time curve of chordoma may provide a radiographic means of distinguishing chordoma from other spinal lesions.

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Sacrococcygeal chordoma: MR imaging in 30 patients

Cited by 81 publications

References 27 publications

Benign Notochordal Cell Tumor of the Sacrum with Atypical Imaging Features: The Value of CT Guided Biopsy for Diagnosis

Benign Notochordal Cell Tumor of the Sacrum with Atypical Imaging Features: The Value of CT Guided Biopsy for Diagnosis

Total resection of inferiorly located sacral chordoma with posterior only approach: case report and review of the literature

T1-Weighted Dynamic Contrast-Enhanced MR Perfusion Imaging Characterizes Tumor Response to Radiation Therapy in Chordoma

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