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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 536-540
DOI: 10.1055/s-0042-1756629
Case Report

Chordoma of the Clivus with Metastasis to Femur

Maruf Matmusaev
1   Department od Skull Base Surgery, Republican Specialized Scientific Practical Medical Center of Neurosurgery, Republic of Uzbekistan, Tashkent, Uzbekistan
2   Department of Neurosurgery, Center of Neuroendoscopy, Nagoya Daini Red Cross Hospital, Nagoya, Japan
,
Tetsuya Nagatani
2   Department of Neurosurgery, Center of Neuroendoscopy, Nagoya Daini Red Cross Hospital, Nagoya, Japan
,
Yugo Kishida
2   Department of Neurosurgery, Center of Neuroendoscopy, Nagoya Daini Red Cross Hospital, Nagoya, Japan
,
Ahmed Ansari
3   Department of Neurosurgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
4   Deparment of Neurosurgery, Fujita Health University Banbuntane Hospital, Nagoya, Japan
› Author Affiliations Funding None.
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Abstract

Chordomas are aggressive and invasive tumors that are notoriously famous for their recurrence and metastasis. They present with diverse manifestations, usually with lower cranial nerve involvement. Here, we present the first reported case of chondroid chordoma with femur metastasis. A 71-year-old lady presented to us with a headache and diplopia. MRI of the brain revealed an enhanced broad and destructive mass in the infrasellar region with complete destruction of the clivus, right cavernous sinus. She underwent multiple surgeries along with gamma knife and proton therapy. The patient later presented with a trochanteric fracture and needed a hip replacement. Biopsy curettage of the femur lesion revealed a chondroid chordoma of the femur. The patient died later of a chest infection. Multimodality treatment is required in chordoma management, including surgery, gamma knife, and proton therapy. A firm discerning eye is required in the elderly toward metastatic spread to the femur in cases presenting with fractures of long bones.

Keywords

chordoma - clivus - metastasis - femur


Publication History

Article published online:
12 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Asano S, Kawahara N, Kirino T. Intradural spinal seeding of a clival chordoma. Acta Neurochir (Wien) 2003; 145 (07) 599-603 , discussion 603
    CrossrefPubMedGoogle Scholar
  • 2 Walcott BP, Nahed BV, Mohyeldin A, Coumans JV, Kahle KT, Ferreira MJ. Chordoma: current concepts, management, and future directions. Lancet Oncol 2012; 13 (02) e69-e76
    CrossrefPubMedGoogle Scholar
  • 3 al-Mefty O, Borba LA. Skull base chordomas: a management challenge. J Neurosurg 1997; 86 (02) 182-189
    Google Scholar
  • 4 Ito E, Saito K, Nagatani T. et al. Intradural cranial chordoma. World Neurosurg 2010; 73 (03) 194-197 , discussion e31
    CrossrefPubMedGoogle Scholar
  • 5 Warnick RE, Raisanen J, Kaczmar Jr T, Davis RL, Prados MD. Intradural chordoma of the tentorium cerebelli. Case report. J Neurosurg 1991; 74 (03) 508-511
    CrossrefPubMedGoogle Scholar
  • 6 Kim KH. Intradural clival chordoma: a case report. Brain Tumor Res Treat 2014; 2 (02) 76-80
    CrossrefPubMedGoogle Scholar
  • 7 Pamir MN, Kiliç T, Türe U, Ozek MM. Multimodality management of 26 skull-base chordomas with 4-year mean follow-up: experience at a single institution. Acta Neurochir (Wien) 2004; 146 (04) 343-354 , 354
    CrossrefPubMedGoogle Scholar
  • 8 Diaz RJ, Cusimano MD. The biological basis for modern treatment of chordoma. J Neurooncol 2011; 104 (02) 411-422
    CrossrefPubMedGoogle Scholar
  • 9 Stacchiotti S, Casali PG, Lo Vullo S. et al. Chordoma of the mobile spine and sacrum: a retrospective analysis of a series of patients surgically treated at two referral centers. Ann Surg Oncol 2010; 17 (01) 211-219
    CrossrefPubMedGoogle Scholar
  • 10 Chugh R, Tawbi H, Lucas DR, Biermann JS, Schuetze SM, Baker LH. Chordoma: the nonsarcoma primary bone tumor. Oncologist 2007; 12 (11) 1344-1350
    CrossrefPubMedGoogle Scholar
  • 11 Alshammari J, Monnier P, Daniel RT, Sandu K. Clival chordoma with an atypical presentation: a case report. J Med Case Reports 2012; 6: 410
    CrossrefPubMedGoogle Scholar
  • 12 Kitai R, Yoshida K, Kubota T. et al. Clival chordoma manifesting as nasal bleeding. A case report. Neuroradiology 2005; 47 (05) 368-371
    CrossrefPubMedGoogle Scholar
  • 13 Alli A, Clark M, Mansell NJ. Cerebrospinal fluid rhinorrhea secondary to ecchordosis physaliphora. Skull Base 2008; 18 (06) 395-399
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Andijani M, Jamjoom A, Togersen A, Ram B, Bodkin P, Kamel M. An unusual presentation of clival chordoma: a case report and review of the literature. Br J Neurosurg 2020; 34 (05) 549-551
    CrossrefPubMedGoogle Scholar
  • 15 Sepulveda I, Schmidt T, Ayres G, Vera P, Fredes F. Synchronous infrasellar and cervical chondroid chordoma: a case report and review of the literature. J Med Cases 2017; 8: 127-131
    CrossrefGoogle Scholar
  • 16 Erazo IS, Galvis CF, Aguirre LE, Iglesias R, Abarca LC. Clival chondroid chordoma: a case report and review of the literature. Cureus 2018; 10 (09) e3381
    PubMedGoogle Scholar
  • 17 Kim SC, Cho W, Chang UK, Youn SM. Two cases of dedifferentiated chordoma in the sacrum. Korean J Spine 2015; 12 (03) 230-234
    CrossrefPubMedGoogle Scholar
  • 18 Ruiz HA, Goldberg LH, Humphreys TR, Blacklock JB. Cutaneous metastasis of chordoma. Dermatol Surg 2000; 26 (03) 259-262
    CrossrefPubMedGoogle Scholar
  • 19 Prompona M, Linn J, Burdorf L. et al. Pulmonary vein metastasis of a sacral chordoma extending into the left atrial cavity. J Cardiovasc Med (Hagerstown) 2009; 10 (07) 557-559
    CrossrefPubMedGoogle Scholar
  • 20 Ito E, Saito K, Okada T, Nagatani T, Nagasaka T. Long-term control of clival chordoma with initial aggressive surgical resection and gamma knife radiosurgery for recurrence. Acta Neurochir (Wien) 2010; 152 (01) 57-67 , discussion 67
    CrossrefPubMedGoogle Scholar
  • 21 Matsuno A, Sasaki T, Nagashima T. et al. Immunohistochemical examination of proliferative potentials and the expression of cell cycle-related proteins of intracranial chordomas. Hum Pathol 1997; 28 (06) 714-719
    CrossrefPubMedGoogle Scholar
  • 22 Holton JL, Steel T, Luxsuwong M, Crockard HA, Revesz T. Skull base chordomas: correlation of tumour doubling time with age, mitosis and Ki67 proliferation index. Neuropathol Appl Neurobiol 2000; 26 (06) 497-503
    CrossrefPubMedGoogle Scholar