Combined therapy for distant metastasis of sacral chordoma.

Birol Özkal,Cüneyt Temiz,Can Yaldız,Peyker Temiz

doi:10.1155/2015/165162

Abstract

Chordomas are known as rare primary malign tumours that have formed from primitive notochord remains. Sacral chordomas grow slowly but locally and aggressively. Chordomas are locally invasive and have low tendency to metastasis and have a poor prognosis in long-term follow-up. Metastasis may be seen in a rate of 5–40% of the chordomas. Metastasis of chordomas is common in liver, lung, lymph nodes, peritoneum, and brain. The treatment approaches, including surgery, have been discussed in the literature before. Susceptibility to radiotherapy and chemotherapy is controversial in these tumours. The success of surgical treatment affects survival directly. In this report, we will report a sacral chordoma case in which an intraperitoneal distant metastasis occurred and discuss the surgical approach.

Highlights

ObjectiveChordomas are low-grade, rare, and primarily malign tumors that grow slowly
Chordomas are known as rare primary malign tumours that have formed from primitive notochord remains
Metastasis of chordomas is common in liver, lung, lymph nodes, peritoneum, and brain

Summary

Objective

Chordomas are low-grade, rare, and primarily malign tumors that grow slowly They rarely have distant metastasis, but instead more locally recurrent tumors grow from primitive notochordal cell remnants. We report a case of sacral chordoma in a 53-year-old male with a distant metastasis to the peritoneal region; such a case has never been published before. Postoperative MRI showed total excision of the tumor and no local or distant metastasis. Conformal complex radiotherapy was applied to the anterior and posterior sacral region; the fractions of the radiation were 6,000 and 200 centigray. At early postoperative evaluations (one and three months), no local recurrence or distant metastasis was found. The patient went through a radiological examination in the nine-month follow-up, and no local recurrence was detected in the sacrococcygeal region. Neither MRI nor PET-CT scans showed any recurrence, either locally or distantly

Discussion

Findings

Conclusion