RESUMO
INTRODUCTION: Chordoma metastases are usually found at advanced stages of the disease. The metastases occur generally in lung, bones, liver and lymph nodes. We report a rare case of radicular chordoma metastasis. CLINICAL CASE: A 59-year-old man, operated for a clival chordoma six years ago, was admitted for atypical S1 radiculopathy. The MRI showed lumbar intradural tumor compressing the cauda equina. Surgery was performed. RESULTS: After opening of the dura mater, the tumor was seen tightly attached to the nerve roots and was totally removed. The histological examination confirmed a metastasis of the known chordoma without local recurrence. CONCLUSION: Chordomas are slowly growing, aggressive malignancies. Mostly complete microsurgical resection reduces local and distant recurrences. Intradural metastases are rare and follow cerebrospinal fluid dissemination from tumor cells. These metastases must be actively cured to achieve longer survival and better quality of life.
Assuntos
Cordoma/secundário , Neoplasias da Base do Crânio/patologia , Neoplasias da Medula Espinal/secundário , Cauda Equina/patologia , Cordoma/líquido cefalorraquidiano , Cordoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Microcirurgia , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Procedimentos Neurocirúrgicos , Radiculopatia/etiologia , Radiculopatia/patologia , Neoplasias da Base do Crânio/líquido cefalorraquidiano , Neoplasias da Base do Crânio/cirurgia , Medula Espinal/patologia , Neoplasias da Medula Espinal/cirurgiaRESUMO
The cytologic findings on cerebrospinal fluid examination of cervical chordoma in a 2-year-old girl are presented. The major cell type was a small, isolated, hyperchromatic cell with sharply defined nuclear membrane and granular cytoplasm. However, the characteristic cell of this neoplasm, the so-called physaliferous cell with typical bubbly cytoplasm, was also noted. Cytologic findings were compared to biopsy findings, with a good correlation of tumor morphology. Clinical follow-up revealed unusually aggressive tumor behavior, and the patient died a year later despite intensive chemotherapy. The differential diagnosis of the condition is also discussed.
Assuntos
Neoplasias Encefálicas/líquido cefalorraquidiano , Cordoma/líquido cefalorraquidiano , Neoplasias de Cabeça e Pescoço/líquido cefalorraquidiano , Neoplasias da Medula Espinal/líquido cefalorraquidiano , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Pré-Escolar , Cordoma/diagnóstico , Cordoma/patologia , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Pulmonares/secundário , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/patologiaRESUMO
Os autores analisaram 7 casos de cordomas raquimedulares cervicais operados no serviço no período de 38 anos, juntando-se a alguns casos de serviços privados. Säo analisadas a epidemiologia, os sintomas, sinais, achados neurológicos, mielográficos, conduta cirúrgica e o follow-up de 7 casos do serviço. Fazem também um estudo da literatura mundial pertinente ao assunto
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Idoso , Humanos , Masculino , Feminino , Neoplasias da Medula Espinal , Cordoma , Neoplasias da Medula Espinal/líquido cefalorraquidiano , Neoplasias da Medula Espinal , Cordoma/líquido cefalorraquidiano , Cordoma , Mielografia , Tomografia Computadorizada por Raios XRESUMO
This is a case report of a 44-year-old man with a chordoma of the clivus that caused dysphonia, low back pain, and urinary and fecal incontinence. The diagnosis was made by cytologic study of the CSF, which demonstrated vacuolated malignant cells. The patient was treated with intrathecal methotrexate, dexamethasone, and radiotherapy. At autopsy extensive dissemination of chordoma was found at the base of the brain, in the ventricles, and in the leptomeninges of the spinal cord. This is the sixth reported case of intrathecal dissemination of a chordoma and the first diagnosed by cytology of the cerebrospinal fluid.
