Spontaneous regression of a clival chordoma. Case report

Bander, Evan D; Kocharian, Gary; Liechty, Benjamin; Tsiouris, Apostolos John; Schwartz, Theodore H.

doi:10.1007/s00701-019-04107-9

Cited by 4 publications

(16 citation statements)

References 16 publications

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“…Maximal surgical resection and local high-dosage radiation have become the primary treatment course, as there is poor response to other treatment strategies. [1][2][3][4][5] Spontaneous regression of clival chordomas had never been described to the best of our knowledge, until Bander et al 1 published a recent case report, followed by Passeri et al 3 We present here what we believe to be the third case report of spontaneous regression of a clival chordoma and discuss similarities of cases and implications for clinical practice.…”

Section: Introductionmentioning

confidence: 56%

“…Chordomas are rare, locally aggressive neoplasms of notochordal origin, constituting 2 to 4% of primary bone tumors. [1][2][3][4][5] They characteristically tend to recur.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous regression of chordomas is rare, and there were no descriptions of clival chordoma regression until Bander et al 1 described a case report of spontaneous regression of a clival chordoma in a 75-year-old woman without surgical excision or radiation therapy. The patient in the case described was taking multiple medications including several herbal supplements and animal oils.…”

Section: Discussionmentioning

confidence: 99%

“…Chordoma is a malignant and aggressive tumor originating from remnants of the primitive notochord and usually involving the axial skeleton. [1][2][3][4][5] It has an incidence of approximately 35% in the clivus and 50% in the sacrococcygeal region. Chordomas account for 1% of all primary brain tumors.…”

Section: Introductionmentioning

confidence: 99%

“…Natural history of chordoma is characterized by local growth and invasion and propensity to recur. [1][2][3][4][5] For clival chordomas, symptom onset is insidious and includes diplopia associated with cranial nerve palsies and headache. Maximal surgical resection and local high-dosage radiation have become the primary treatment course, as there is poor response to other treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Regression of a Clival Chordoma: An Unusual Case Report

Vellutini

Stamm

Oliveira

2021

J Neurol Surg A Cent Eur Neurosurg

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Introduction Chordoma is a malignant and aggressive tumor originating from remnants of the primitive notochord and usually involving the axial skeleton. Spontaneous regression of clival chordomas was described recently. We present the third case report of spontaneous regression of a clival chordoma and discuss similarities of cases and implications for clinical practice. Case Description We present the case of a previously healthy 21-year-old Caucasian woman who presented with progressive holocranial headache for 3 months, which encouraged image investigation. Magnetic resonance imaging (MRI) revealed an osteolytic clival lesion hyperintense in T2 and hypointense in T1 images. After 2 months of initial evaluation and surgical proposal, she repeated MRI to allow use for intraoperative neuronavigation. Surprisingly, there was tumor regression. Discussion The present reported case is somehow different from previous ones and does not share an underlying inflammatory/immunological recognizable fact, being interpreted by us as a spontaneous partial regression of the tumor. We highlight the need for continuous investigation of chordoma regression to uncover the underlying mechanisms.

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Section: Introductionmentioning

confidence: 56%

“…Chordomas are rare, locally aggressive neoplasms of notochordal origin, constituting 2 to 4% of primary bone tumors. [1][2][3][4][5] They characteristically tend to recur.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Spontaneous Regression of a Clival Chordoma: An Unusual Case Report

Vellutini

Stamm

Oliveira

2021

J Neurol Surg A Cent Eur Neurosurg

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Sacrococcygeal chordoma with spontaneous regression due to a large hemorrhagic component

González,

Lam,

van der Wal

et al. 2024

Skeletal Radiol

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Chordoma is a malignant bone tumor originating from notochordal remnants, most commonly occurring at the sacrococcygeal junction. We present a case of a 70-year-old male with chronic pain in the lower lumbar spine. MRI performed elsewhere revealed a large tumor that involved S4, S5, and the coccyx with a presacral soft tissue component. The lesion was heterogeneously hyperintense on T2-weighted images with a thick hypointense rim anteriorly. On T1-weighted images, the lesion showed a native hyperintense signal centrally probably due to hemorrhage. Based on this MRI, the diagnosis of chordoma was suggested. A spontaneous marked reduction in size was observed on a 4-week interval MRI performed at our institution before biopsy. Due to spontaneous tumor shrinkage along with peripheral enhancement, a differential diagnosis of infection or bleeding in a retrorectal cyst was proposed. This case teaches us that chordomas may contain a large hemorrhagic component, which is hyperintense on T1-weighted images and shows peripheral rim enhancement. Spontaneous shrinkage of a tumor may occur due to the resolution of a hematoma within weeks. Biopsy is key to obtain the correct diagnosis. Understanding the typical and more rare features of chordomas is key for MSK radiologists as well as pathologists. Chordomas are typically slow-growing tumors, but radiologists should be aware that intratumoral hemorrhage can lead to rapid changes in tumor size, which may be mistaken for either regression or progression of tumor. This case highlights the importance of considering hemorrhagic events within chordomas in the differential diagnosis when observing size fluctuations on imaging.

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Frontal ghost tumour: a case report

Mathew,

Gundu,

Aruna

et al. 2024

Egypt J Neurosurg

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Background Ghost tumors spontaneously disappear or decrease to less than 70% before definitive diagnosis and treatment (other than steroid treatment). We report our experience with a patient who had not received steroids, and the challenges of managing a ghost tumor from a developing country. Case presentation A 71 year old female with frontal mass, right proptosis, and frontal headache. Mass was confirmed by cranial CT scan but entirely resolved while the patient was awaiting surgery. Further follow-up at 6 months revealed clinical and MRI evidence of recurrence. Ghost tumors are no myths and can recur! Conclusion It is imperative to closely follow up with patients who have complete resolution of brain tumors prior to definitive treatment.

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Spontaneous regression of a clival chordoma. Case report

Cited by 4 publications

References 16 publications

Spontaneous Regression of a Clival Chordoma: An Unusual Case Report

Spontaneous Regression of a Clival Chordoma: An Unusual Case Report

Sacrococcygeal chordoma with spontaneous regression due to a large hemorrhagic component

Frontal ghost tumour: a case report

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