Anesthetic Considerations in a Case With Massive Recurrent Clivus Chordoma

Pardis Soltanpoor,Afsoun Seddighi,Faranak Behnaz,Hamidreza Azizi Faresani,Maede Karimian

doi:10.15171/icnj.2019.15

Abstract

Chordomas rare low grade slow-growing malignant tumors with an incidence rate of 1 in 100000 individuals.32% of chordomas occur in the clivus. Diagnosing Clival chordomas could be challenging due to their rare prevalence, insidious onset, and tendency to involve anywhere throughout the craniospinal column. Treating these tumors can also present as a challenge due to their proximity to vital structures and high recurrence rate. We present a case of massive recurrent Clival chordoma in a 27-year-old patient and discuss the anesthetic considerations in such cases.

Highlights

Chordomas are rare slow-growing low-grade malignant tumors of notochordal origin that often have an insidious onset.[1]
Case Report We report a case of clivus chordoma in a 27-year-old male ASA class 1 patient undergoing trans-oral and trans-nasal resection of the tumor with a history of trans-nasal tumor resection ten months before the surgery and 30 sessions of radiotherapy
Magnetic resonance imaging showed a heterogenous skull base mass with extension to the nasopharynx and Anesthetic Considerations in Clivus Chordoma bilateral cerebellopontine angles creating the mass effect on basilar artery consistent with 9, 10 and 12 cranial nerves involvement. (Figure 1B)

Summary

Introduction

Chordomas are rare slow-growing low-grade malignant tumors of notochordal origin that often have an insidious onset.[1]. Case Report We report a case of clivus chordoma in a 27-year-old male ASA class 1 patient undergoing trans-oral and trans-nasal resection of the tumor with a history of trans-nasal tumor resection ten months before the surgery and 30 sessions of radiotherapy.

Results

Conclusion