No abstract available.
Chordoma* ; Diagnosis* ; Neuralgia*

Sacrococcygeal chordoma is a rare malignant tumor which is believed to take its origin from remnants of the fetal notochord, and presents in the sacral hollow or occasionally posteriorly. The growth is leisurely and it is invasive rather than metastatic. In treatment, there is evidence that early diagnosis of sacrococcygeal chordoma followed by radical resection c palliative radiotherapy does provide the opportunity for cure. We have experienced two cases of sacrococcygeal chordoma, which were treated with one case of a complete surgical resection and the other case of only biopsy.
Biopsy ; Chordoma ; Early Diagnosis ; Notochord ; Radiotherapy

The various pathologic conditions detected at CT and MRI and subsumed by the term "sacral tumor" include primary bone tumors, sacral canal tumors and metastases. Among these, metastases are much more common than primary bone tumors, of which chordoma is the most common. Although the imaging findings of sacral tumors are nonspecific, a patient's age and sex, and specific findings such as calcification or fluid-fluid levels, can help radiologists in their differential diagnosis. We describe the imaging findings of primary sacral tumors, emphasizing the MRI findings.
Chordoma ; Diagnosis, Differential ; Magnetic Resonance Imaging ; Neoplasm Metastasis

Parachordoma is a very rare, slow-growing, and low-grade malignant tumor that occurs in the extremities and trunk. The differential diagnosis includes extraskeletal myxoid chondrosarcoma and chordoma in the histologic finding. Thus, histologic findings with immunohistochemistry may be helpful in distinguishing parachordoma from extraskeletal myxoid chondrosarcoma and chordoma. I report with a brief review of literatures one case of parachordoma of the chest wall which was successfully treated by en-bloc resection and chest wall reconstruction using 2 mm Gore-Tex(R) soft tissue patch and free from recurrence for 16 months.
Chondrosarcoma ; Chordoma ; Diagnosis, Differential ; Extremities ; Immunohistochemistry ; Recurrence ; Thoracic Wall* ; Thorax*

Cytologic features of conventional chordoma have been described and most reports emphasize the presence of large cells with numerous well defined cytoplasmic vacuoles or physaliferous cells. We report fine needle aspiration cytologic (FNAC) findings of a case of chordoma without physaliferous cells. The smear was cellular and composed of large cohesive clusters or individually scattered cells in mucinous background. The round or cuboidal cells had centrally located nuclei with fine granular chromatin, inconspicuous nucleoli, and occasional vacuolated cytoplasm. Mild to moderate pleomorphism was noted. Physaliferous cells are extremely helpful when present in cytologic material, but they are not necessary for diagnosis. Thus clinical history, roentgenographic appearance, and exact location of the lesion are required for the successful interpretation of presacral aspirates together with cytologic findings.
Biopsy, Fine-Needle ; Chordoma* ; Chromatin ; Cytoplasm ; Diagnosis* ; Mucins ; Vacuoles

UNLABELLED: The patient was hospitalized for sudden hearing impairment for one day. PHYSICAL EXAMINATION: the blood pressure was 150/90 mm Hg, the tympanic membranes in both ears were complete and otopiesis. Audiogram showed total deafness in the right ear and slight sensorineural deafness at speech frequency and 80 db for high tone air conduction and 70 db for bone conduction at high frequency in left ear. Tympanogram showed "A" type in both ears and the ipsilateral and contralateral acoustic reflex in both ears were not induced. BAEP showed that the V wave threshold on the right was not induced and it was 50 dbnHL on the left. CT showed a limited low density area in the clivus. MRI showed a space-occupying lesion behind the basilar clivus and ahead of brain stem. Pathological examination showed CK(+), EMA(+), S-100(+) according to immunohistochemistry, which was in accordance with chondroid chordoma. DIAGNOSIS chondroid chordoma of clivus.
Chordoma ; complications ; diagnosis ; Female ; Hearing Loss, Sudden ; diagnosis ; etiology ; Humans ; Middle Aged ; Skull Neoplasms ; complications ; diagnosis

Dedifferentiated chordoma (DC) is defined as a chordoma containing sarcoma components. DC is distinguished from conventional chordoma by the rapidity of tumor growth and the potential for distant metastasis. We report two cases of DC, which are developed in the sacrum. We reviewed the medical records and imaging studies of 2 patients diagnosed with DC and the literature published. In the first case, percutaneous biopsy revealed that it was conventional chordoma in the sacrum. Patient underwent radiation therapy (RT). Six years after the RT, the tumor recurred. Surgical removal was performed and the recurrent tumor was diagnosed as DC in histopathologic examination. In the second case, a patient underwent gross total resection of sacral tumor, which was diagnosed with conventional chordoma. Aggravated tumor was detected after 4 months, and patient underwent reoperation. The second operation revealed the transformation of the tumor into DC. The survival time of the patients after the diagnosis was 10 and 31 months. Dedifferentiated chordoma is a rare and highly aggressive tumor. De novo type exists, but it usually transformed from recurrent chordoma after surgical resection or radiation.
Biopsy ; Chordoma* ; Diagnosis ; Humans ; Medical Records ; Neoplasm Metastasis ; Reoperation ; Sacrum* ; Sarcoma

OBJECTIVE: The purpose of this study was to present the MRI and CT findings of solitary spinal bone lesions (SSBLs) with the aims of aiding the differential diagnoses of malignant tumors and benign lesions, and proposing a diagnostic strategy for obscure SSBLs. METHODS: The authors retrospectively reviewed the imaging findings of 19 patients with an obscure SSBL on MRI at our hospital from January 1994 to April 2011. The 19 patients were divided to benign groups and malignant groups according to final diagnosis. MRI and CT findings were evaluated and the results of additional work-up studies were conducted to achieve a differential diagnosis. RESULTS: At final diagnoses, 10 (52.6%) of the 19 SSBLs were malignant tumors and 9 (47.4%) were benign lesions. The malignant tumors included 6 metastatic cancers, 3 multiple myelomas, and 1 chordoma, and the benign lesions included 4 osteomyelitis, 2 hemangiomas, 2 nonspecific chronic inflammations, and 1 giant cell tumor. No MRI characteristics examined was found to be significantly different in the benign and malignant groups. Reactive sclerotic change was observed by CT in 1 (10.0%) of the 10 malignant lesions and in 7 (77.8%) of the 9 benign lesions (p=0.005). CONCLUSION: Approximately half of the obscure SSBLs were malignant tumors. CT and MRI findings in combination may aid the differential diagnosis of obscure SSBLs. In particular, sclerotic change on CT images was an important finding implying benign lesion. Finally, we suggest a possible diagnostic strategy for obscure SSBLs on MRI.
Chordoma ; Diagnosis, Differential ; Giant Cell Tumors ; Hemangioma ; Humans ; Inflammation ; Multiple Myeloma ; Osteomyelitis ; Retrospective Studies

Chordomas are uncommon tumors arising from the embryonic remnants of the fetal notochord. The spheno-occipital region accounts for 36 percent of chordomas. The authors are presenting four cases of intracranial chordomas with clinical manifestation was analyzed. All patients were men and their mean age was 37 years old. The presenting complaints were diplopia in 2 patients and decreased visual acuity in the order two. Radiologic studies demonstrated extensive bony destruction of the skull base and soft mass with punctate calcification in all 4 cases. Treatment consisted of subtotal removal of tumor and subsequent radiotherapy. Histopathologically, three of the four patients had typical chordomas and the remaining case was confirmed as chondroid chordoma. The three typical chordomas recurred after initial treatment. 2 of these three were reoperated but died in the 10 months and 33 months, respectively after initial diagnosis. The patient with chondroid chordoma remained well for 46 months after initial treatment without significant neurological deficits. In conclusion, therapeutic outcome of intracranial chordomas are grim because of their aggressive that, frequent recurrence and inability to remove tumors completely. With the exception, chondroid chordoma had good prognosis and long term survival.
Adult ; Chordoma ; Diagnosis ; Diplopia ; Humans ; Male ; Notochord ; Prognosis ; Radiotherapy ; Recurrence ; Skull Base ; Visual Acuity

A case of chordoma occurred in the right femoral head and gluteus maximus muscle is reported. The case was a 61 year old female who complained of severe painful limitation of motion of the hip and radiating pain to the posterior aspect of right thigh for ten months. Roentgenological study revealed pathological fracture of femoral neck with osteoporotic change. For the treatment of femoral neck fracture, Moore type prosthetic femoral head replacement was performed. The cut surface of the resected femoral head showed multiple necrotic foci here and there, whitishgrey in color and gellatinous in consistency. The diagnosis was confirmed as a chordoma by microscopic examination. Femoral head and gluteus maximus muscle is one of very rare site of chordoma in the previous literature.
Chordoma ; Diagnosis ; Female ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Humans ; Thigh