Spinal chordomas

Abstract

A series of 54 patients with spinal chordomas were treated at Memorial Sloan-Kettering Cancer Center between 1949 and 1976. Thirty-six lesions were located in the sacrococcygeal region and 18 involved the vertebral column at a higher level. The male to female ratio was 35:19. Vertebral chordomas generally occurred in a younger age group. Our radiological findings suggest that there is marked soft-tissue extension anterior to the vertebral column at the time of initial diagnosis. Eleven of 18 vertebral chordomas and 10 of 36 sacral chordomas were found to have disseminated metastases during their course. Analysis of the various modes of therapy reveals that the median survival for both groups is approximately 6 years. However, the 5-year survival for the sacrococcygeal group was 66% as opposed to 50% for the vertebral group. Radiation therapy produced significant palliation but objective evidence of tumor regression was difficult to assess. Chemotherapy in a small number of patients did not have any effect on the tumor. With the advent of computerized tomography scanning, further studies should be done to document the response of this tumor to radiation therapy.

A Case of Coccygeal Chondroid Chordoma in a Cat: Morphological and Immunohistochemical Features

“…10 The nucleus pulposus is believed to be the only derivative of notochordal tissue. 13 Three distinct types of chordoma are recognized in humans: 1) the classic chordoma, 2) chondroid chordoma, and 3) chordoma with a malignant spindle cell component. The classic chordoma is a slow-growing, locally aggressive neoplasm with a high rate of recurrence, particularly in those of sacrococcygeal or vertebral origin; chondroid chordoma arises primarily in the spheno-occipital region and is characterized by chondromatous and chordomatous features.…”

Combined Anterior and Posterior En Bloc Vertebrectomy for Lumbar Chordoma

“…This anatomical distribution supports the generally accepted theory that it arises from notochordal remnants. As mentioned above, it is usually found in the clivus and sacrum and infrequently in the lumbar spine 11) . When adequate excision is not possible, radiation therapy may provide at least a short-term benefit.…”

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

“…Chordoma is an unusual disease accounting for only 1-5% of all osseous neoplasms [1,2] but nevertheless remains the most common primary neoplasm of the spinal column. Prompt recognition and treatment of this condition is warranted since its clinical course and treatment are markedly distinct from the much more common diagnosis in the differential for spinal column tumors, namely, metastases from other primary malignancy [3].…”

“…Despite the putative embryological derivation, the most commonly affected age group is middleaged adults with most series listing the average age at presentation in the sixth decade [2,3,5,6]. Chordomas arise preferentially at two distinct sites along the spinal axis: the sacrococcygeal (50-60% of all cases) and sphenooccipital (35-40%) junctions [1,7]. Chordomas arising from the so-called ''mobile'' spine are much less common and account for less than 15% in most series [3].…”