جستجوی مقالات مرتبط با کلیدواژه « chordoma » در نشریات گروه « پزشکی »

Chordoma is a bone tumor that is resistant to radiotherapy, and few studies have been published on the concomitant use of radiotherapy in combination with hyperthermia in its treatment. We reported a chordoma patient treated with both radiotherapy and hyperthermia. The patient was a 74-year-old man with chordoma who underwent radiotherapy combined with hyperthermia due to his unwillingness to undergo surgery and responded very well clinically and imaging-wise without increasing in complications. Radiotherapy combined with hyperthermia improves the response to treatment (both clinically and in imaging) and does not increase the complications.

Chordomas are rare tumors from primitive notochord. They are usually located at sacrococcygeal region when it affects the spine. We present a case of giant chordoma in the thoracolumbar spine in Peru. A 43-year-old woman came to the hospital in Huanuco due to back pain and sensorymotor alterations in the lower limbs. Imaging confirmed an unresectable tumor involving the spine. Two years later, she came back with paraplegia, weight loss, severe anemia and complicated urinary tract infection. Magnetic resonance imaging confirmed a mass measuring 15×15×14 cm in T11, T12 and L1 which histopathology was consistent with chordoma. Chordoma is a rare tumor which should be included in the differential diagnosis of spinal tumors. An earlier diagnosis leads to more options of treatments and longer survival.

Chordoma is a rare bone cancer which arises from undifferentiated notochordal remnants in the axial skeleton. It generally has slow-growing and locally aggressive behavior. This tumor is usually diagnosed by CT and MRI modalities and the role of SPECT/CT is still debated. It shows reduced or normal uptake of radioisotope on bone scanning and increased tracer uptake is infrequently reported. Here we present a 33-year-old man with complaint of low back pain and numbness of his right leg. The whole body bone scan showed relatively uniform radiotracer activity throughout the skeleton. A focal increased uptake in the second lumbar vertebra was noted on SPECT/CT images. SPECT/CT also demonstrated multiple lytic lesions in lumbar vertebrae. The lesions were proven to be chordoma on biopsy. Lumbar chordoma could be one of the differential diagnoses for lytic lesions of the vertebrae which show absent or minimal tracer uptake on bone scintigraphy and SPECT/CT imaging. Our case was unusual as the patient was very young for chordoma diagnosis and bone scan showed increased uptake adjacent to the involved vertebral lesion detected by SPECT/CT.

  Although CT morphological characteristics of giant cell tumors (GCTs) of the sacrum have been reported in the literature, the enhanced CT quantitative characteristics of GCTs have not been extensively evaluated. The aim of our study was to analyze the enhancement characteristics of giant cell tumors of the sacrum. Patients and Sixty-one cases were reviewed, including 20 GCTs, 22 sacral chordomas (SCs) and 19 sacral schwannomas (SSs). The CT images of all the three types of tumors were retrospectively analyzed. The enhancement index (EI) of each mass was calculated by the formula: EI(a/v) = [D(a/v) - D(pre)]/D(pre), where D(a/v) was the density of the mass on the enhanced CT (a = arterial phase; v = portal venous phase), and D(pre) was the density of the mass on the pre-enhanced images. The maximum enhancement (Emax) was determined by the following equation: Emax = D(v) - D(pre). The parameters of the different enhancement phases among the 3 groups were compared with One-way ANOVA. On the noncontrast images, the densities of the SCs were lower than those of the GCTs and SSs, but there was no difference between the GCTs and SSs (P > 0.05). In the arterial phase, the EIa of the GCTs was the highest among the three groups (P < 0.05), and that of the SCs was the lowest. In the venous phase, the EIv of the GCTs was higher than that in the arterial phase and was also the highest among the three groups (P < 0.05). A difference was found among the groups, namely, the GCTs, SCs, and SSs (P < 0.05). The EIa and EIv of the SCs were the lowest among the three groups. The Emax of the GCTs was the highest among the three groups (P < 0.05). Quantitative analysis of the characteristics of contrast-enhanced CT is a useful method for diagnosing sacral GCTs and differentiating these tumors from SCs and SSs.

The clivus is the surface of a portion of the occipital and sphenoid bones in the base of the skull. (1)It is surrounded by the neurovascular structures of the brainstem, as well as internal carotid arteries. Tumors of the clivus can be benign (chordoma)or malignant (chondrosarcoma).(2) Chordomas are rare, aggressive, slow-growing, invasive, and locally destructive tumors that arise from the notochord, a structure that appears in embryonic stages and guides the growth of the bony skull and spine. Normally, notochordal remnants form part of the intervertebral discs. A chordoma occurs when additional notochordal cells are enclosed by the developing bones. Although these tumors are benign and slow-growing, they may invade nearby structures and destroy surrounding tissue and spread to other parts of the body.(2)Most arachnoid cysts are probably present at birth, or develop soon after. Once they are formed, they are thought to remain stable, apparently in some kind of equilibrium with the rest of the intracranial space(3). We report a rare case of clivus chordoma associated with an arachnoid cyst.

Chordomas are low-grade malignant tumors of bone that occur almost exclusively in the axial skeleton. Chordomas are rare in children and adolescents and comprise <5% of all cases and the site of development is at the skull base. These tumors are believed to behave more aggressively than chordomas in adults and may have unusual morphology. We herein present a rare case of chordoma in a 20-year-old male with low back mass, diagnosed on fine needle aspiration cytology.

Despite the relative success of surgical resection followed by proton, proton/photon, or conventional radiotherapy in terms of recurrence-free survival, chordomas are still associated with a high rate of recurrence. To our knowledge there are only very few reported cases of this rare tumor detected by F-18 FDG-PET. In this case we show the significance of F-18 FDG-PET/CT in detection of recurrent Chordoma in a 38 year old man with a history of the disease and a newly detected cervical lymphatic mass. The fused PET/CT images manifested the presence of two abnormal foci of tracer uptake corresponding to a retroclavicular and an infrajugular Lymph node proved to be metastases of the previous chordoma in histopathology. Further employment of F-18 FDG-PET/CT in this rare tumour type might eventually define and establish its value in staging of chordoma.

Sarcomatous transformation (dedifferentiated chordoma) in chordoma is a very rare condition and has been emphasized as a distinct entity because of its more aggressive clinical course. Here we describe a case of dedifferentiated chordoma arising from the sacrococcygeal region of a 60-year-old man, in third tumor recurrence. This tumor showed features of sarcoma with areas more typical of chordoma The chordoma-like areas expressed cytokeratin, epithelial membrane antigen and S-100 protein in all tumor cells and the spindle-cell component exhibited vimentin positivity in all of them but negative for other markers. The results showed that the sarcomatous areas as seen in the recurrent chordoma lack epithelial cell features of chordoma and suggest the possibility of altered differentiation pathway of the tumor stem cell or emergence of a new malignant cell population within the recurrent tumor.