1.Primary extra-axial chordoma of femur: report of a case.
Mei WANG ; Hai LI ; Ying DING ; Guo Xin SONG ; Li Li CHENG ; Yan ZHU
Chinese Journal of Pathology 2023;52(1):64-66
2.Endoscopic surgery for huge chordoma in highland: a case report.
Hong-tian WANG ; Zong-xi BAI ; Yue-bing MA
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2010;45(11):957-958
Adult
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Altitude
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Chordoma
;
surgery
;
Endoscopy
;
Female
;
Humans
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Nasal Cavity
;
surgery
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Paranasal Sinuses
;
surgery
;
Skull Base
;
surgery
;
Video-Assisted Surgery
3.Primary chordoma of the nose.
Chinese Medical Journal 2003;116(1):154-156
Aged
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Chordoma
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pathology
;
surgery
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Humans
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Immunohistochemistry
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Male
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Nose Neoplasms
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pathology
;
surgery
4.Transphenoidal-upslope approach by lateral rhinotomy to chordoma invading the sphenoid bone and clivus.
Xixiong GUO ; Qianxue CHEN ; Qingquan HUA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(17):807-808
This paper reported one patient who was treated through transphenoidal-upslope approach by lateral rhinotomy and the tumor was successfully removed. The patient was male of 38 years old. He suffered intermittent headache with blurred vision and left eye outreach disorder for more than a year. The visual inspection showed there was dark area of the left eye lateral. CT showed slopes density placeholder and bone window showed the slope of bone quality had been severely damaged. MRI showed T1 image slopes parts and other low signal placeholder forward to invade the sphenoid sinus. In addition, there was undermine the slope bone and brain stem boundaries clearly and T2 images showed high-signal, inhomogeneous enhancement. We found during the operation that the slope was partially destroyed and part of the tumor was prominent to the pharynx tumor. The pathologic examination confirmed that it is chordoma.
Adult
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Chordoma
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surgery
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Cranial Fossa, Posterior
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surgery
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Humans
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Male
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Microsurgery
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methods
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Skull Base Neoplasms
;
surgery
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Sphenoid Bone
;
surgery
5.A Case of Endoscopic Removal of Clival Chordoma through Extended Transclival Approach.
Gwan CHOI ; Gi Yoon NAM ; Joo Yeon KIM ; Jae Hwan KWON
Korean Journal of Otolaryngology - Head and Neck Surgery 2014;57(8):543-547
Clival chordoma is a rare malignant tumor which arises from the remnants of notochord. Although it is a slow-growing tumor that rarely metastasize to other organs, it is regarded as clinically malignant because of local invasiveness and high recurrence rate. Furthermore, because its location is critical and surgical resection is difficult, it has poor prognosis. Neurosurgeons have traditionally taken the lead in managing tumor, however, with the development of endoscopic techniques and wide spread of usage in skull base surgery, the role of ENT surgeon has become bigger recently. We report a recent case of recurrent clival chordoma successfully removed by endoscopic extended transclival approach.
Chordoma*
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Cranial Fossa, Posterior
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Natural Orifice Endoscopic Surgery
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Notochord
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Prognosis
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Recurrence
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Skull Base
6.Diagnostic Clues and Treatment of Intradural Cranial Chordoma.
Han-Hai ZENG ; Xiao-Bo YU ; Lin-Feng FAN ; Gao CHEN
Chinese Medical Journal 2016;129(23):2895-2896
7.3D-printed vertebral body in anterior spinal reconstruction after total spondylectomy for patients with cervical chordoma.
Hua ZHOU ; Ren Ji WANG ; Zhong Jun LIU ; Xiao Guang LIU ; Feng Liang WU ; Lei DANG ; Feng WEI
Journal of Peking University(Health Sciences) 2023;55(1):144-148
OBJECTIVE:
To investigate whether 3D-printed artificial vertebral body can reduce prosthesis subsidence rate for patients with cervical chordomas, through comparing the rates of prosthesis subsidence between 3D printing artificial vertebral body and titanium mesh for anterior spinal reconstruction after total spondylectomy.
METHODS:
This was a retrospective analysis of patients who underwent surgical treatment for cervical chordoma at our hospital from March 2005 to September 2019. There were nine patients in the group of 3D artificial vertebral body (3D group), and 15 patients in the group of titanium mesh cage (Mesh group). The patients' characteristics and treatment data were extracted from the medical records, including age, gender, CT hounsfield unit of cervical vertebra and surgical information, such as the surgical segments, time and blood loss of surgery, frequency and degree of prosthesis subsidence after surgery. Radiographic observations of prosthesis subsidence during the follow-up, including X-rays, CT, and magnetic resonance imaging were also collected. SPSS 22.0 was used to analysis the data.
RESULTS:
There was no significant difference between the two groups in gender, age, CT hounsfield unit, surgical segments, time of surgery, blood loss of posterior surgery and total blood loss. Blood loss of anterior surgery was 700 (300, 825) mL in 3D group and 1 500 (750, 2 800) mL in Mesh group (P < 0.05). The prosthesis subsidence during the follow-up, 3 months after surgery, there was significant difference between the two groups in mild prosthesis subsidence (P < 0.05). The vertebral height of the 3D group decreased less than 1 mm in eight cases (no prosthesis subsidence) and more than 1 mm in one case (mild prosthesis subsidence). The vertebral height of the Mesh group decreased less than 1 mm in five cases (no prosthesis subsidence), and more than 1 mm in eight cases (mild prosthesis subsidence). Two patients did not have X-rays in 3 months after surgery. There was a statistically significant difference between the two groups in the prosthesis subsidence rate at the end of 12 months (P < 0.01). The vertebral height of eight cases in the 3D group decreased less than 1 mm (no prosthesis subsidence) and one case more than 3 mm (severe prosthesis subsidence). Four of the 15 cases in the Mesh group decreased less than 1 mm (no prosthesis subsidence), two cases more than 1 mm (mild prosthesis subsidence), and nine cases more than 3 mm (severe prosthesis subsidence). There was a statistically significant difference between the two groups in the prosthesis subsidence rate at the end of 24 months (P < 0.01). The vertebral height of seven cases in the 3D group decreased less than 1 mm (no prosthesis subsidence), one case more than 3 mm (severe prosthesis subsidence), and one case died with tumor. One case in the Mesh group decreased less than 1 mm (no prosthesis subsidence), one case more than 1 mm (mild prosthesis subsidence), 11 case more than 3 mm (severe prosthesis subsidence), one case died with tumor and one lost the follow-up. Moreover, at the end of 12 months and 24 months, there was significant difference between the two groups in severe prosthesis subsidence rate (P < 0.01).
CONCLUSION
3D-printed artificial vertebral body for anterior spinal reconstruction after total spondylectomy for patients with cervical chordoma can provide reliable spinal stability, and reduce the incidence of prosthesis subsidence after 2-year follow-up.
Humans
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Chordoma/surgery*
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Retrospective Studies
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Vertebral Body
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Titanium
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Cervical Vertebrae/surgery*
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Printing, Three-Dimensional
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Spinal Fusion/methods*
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Treatment Outcome
8.Endoscopic endonasal surgery for tumors of petroclival region and infratemporal fossa.
Qiu-hang ZHANG ; Hai-sheng LIU ; Feng KONG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2005;40(7):488-492
OBJECTIVENasal endoscope has been used increasingly during skull base surgery. However, most of endoscopic surgery limited to the repair of cerebrospinal rhinorrhea, decompression of traumatic optic nerve, hypophysectomy, etc. This study was undertaken to determine whether endoscopic endonasal approach was safe and effective for the resection of tumors located in petroclival region and infratemporal fossa.
METHODSSeventeen patients with tumors of petroclival region and infratemporal fossa treated by endoscopic endonasal surgery between January 2002 and February 2005 were studied prospectively. The operative technique was described in detail. There were 5 chordoma, 1 esthesioneuroblastoma, 1 chondrosarcoma, 1 lymphoma, 1 craniopharyngioma, 1 hemangioblastoma, 4 meningioma, 1 schwannoma, and 2 metastatic carcinoma. 3 patients were selected for neuronavigation-aided endoscopic endonasal surgery.
RESULTSTotal tumor removal was obtained in 15 cases, subtotal removal in 2 case. With follow-up of 5 to 43 months, 1 case with chordoma was recurrent 5 months later postoperatively and underwent reoperation subsequently. The other cases with benign tumors were no recurrence. All of 5 cases with malignant tumors followed up for longer than 2 years were no recurrence and death. The complications included subarachnoid hemorrhage in 1 patient, transient cerebrospinal leakage in 2 cases.
CONCLUSIONSThe endoscopic endonasal surgery provides satisfied treatment for selected tumors of petroclival region and infratemporal fossa. This approach promises a simple and rapid access to petroclival region and infratemporal fossa. It is a safe, minimally invasive and efficient procedure. Using neuronavigation system, it is helpful to determining anatomical landmark and removing the tumor completely and securely.
Adult ; Aged ; Chordoma ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Meningioma ; surgery ; Middle Aged ; Nose ; surgery ; Petrous Bone ; surgery ; Skull Base Neoplasms ; surgery
9.Computer Navigation-aided Resection of Sacral Chordomas.
Yong-Kun YANG ; Chung-Ming CHAN ; Qing ZHANG ; Hai-Rong XU ; Xiao-Hui NIU
Chinese Medical Journal 2016;129(2):162-168
BACKGROUNDResection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas.
METHODSBetween 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old (range: 35-84 years old). Tumors were located above the level of the S3 neural foramen in 23 patients and below the level of the S3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months (range: 18-84 months).
RESULTSMean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 mm. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 (7.7%) exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 (range: 19-30).
CONCLUSIONSComputer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.
Adult ; Aged ; Aged, 80 and over ; Chordoma ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Sacrum ; surgery ; Spinal Neoplasms ; surgery ; Surgery, Computer-Assisted ; methods ; Treatment Outcome
10.Surgical resection of complex sphenoclival lesions via a whole-course endoscopic extended transsphenoidal approach under neuronavigation: report of 15 cases.
Jun FAN ; Yuping PENG ; Songtao QI ; Jun PAN ; Yuntao LU
Journal of Southern Medical University 2012;32(9):1297-1300
OBJECTIVETo study the clinical value of the whole-course endoscopic extended transsphenoidal approach assisted by neuronavigation in surgical resection of complex sphenoclival lesions.
METHODSImage reconstruction and registration were performed for 15 patients with complex sphenoclival lesions using the neuronavigation system, and the bilateral nasal extended transsphenoidal approach was adopted to remove the lesions with a whole-course endoscopic procedure.
RESULTSPostoperative pathological examination reported pituitary adenomas in 7 cases, chordomas in 5 cases, and cavernous angiomas in 3 cases. Total removal of the lesions was achieved in 10 cases, subtotal removal in 4 cases, and partial removal in 1 case. Transient polyuria occurred in 3 cases and 2 patients experienced temporary cerebrospinal rhinorrhea. No death occurred in these cases after the operation. During the follow-up ranging from 3 to 26 months, only 2 patients with partial lesion removal showed recurrence and received subsequent radiotherapy.
CONCLUSIONThe combination of whole-course endoscopic technique and neuronavigation can help improve the surgical outcomes and reduce complications of complex sphenoclival lesion removal via the extended transsphenoidal approach.
Adult ; Aged ; Chordoma ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neuroendoscopy ; Neuronavigation ; Pituitary Neoplasms ; surgery ; Skull Base Neoplasms ; surgery ; Sphenoid Bone ; pathology ; surgery