Spinal Neoplasms (Subscribe)  

From Neurosurg Focus. 2006;20(2):E2. Posted 03/28/2006
Daniel R. Fassett, M.D., M.B.A.; Randy Clark, M.S.; Douglas L. Brockmeyer, M.D.; Meic H. Schmidt, M.D.
Abstract Postoperative sagittal-plane cervical spine deformities are a concern when laminectomy is performed for tumor resection in the spinal cord. These deformities appear to occur more commonly after resection of...

Clinical presentation: A 60 year old man with increasing weakness in the legs.
The contrast views are oblique views of the cervical spine. The contrast is asymmetrical in the left hand image. The cord is displaced by a lesion, which is compressing the contrast in the sub-arachnoid space. The appearance is of...

Brief notes and links to images for ARRS members

Chordoma is a relatively rare malignant midline tumor arising in the axial skeleton, primarily at its cranial and caudal ends, that is derived from persistent embryonic notochordal cell rests.

4 synonyms or equivalents were found. Chordoma aka/or Notochordoma aka/or Chordocarcinoma aka/or Chordoepithelioma
Chordoma: Definition(s) via UMLS - "A malignant bone tumor arising from the remnants of the fetal notochord. Although it can occur at all ages, it is more frequently seen in middle-aged adults. Most frequent sites of involvement are: sacrococcygeal area, spheno-occipital area, and the cervico-thoraco-lumbar...

Chordomas are rare, clinically malignant tumors derived from notochordal remnants. They occur along the length of the spinal axis, predominantly in the sphenooccipital, vertebral, and sacrococcygeal regions. They are characterized by slow growth, local destruction of bone, extension into adjacent soft tissues, and, rarely, distant metastatic spread.

Contents - Introduction Differentials Radiograph CT Scan MRI Intervention Multimedia References
Chordomas are tumors originating from embryonic remnants of the primitive notochord. Because chordomas lie in bone, they are usually extradural and induce bone destruction.

Clinical presentation: 69 year old woman with back pain and pain and left 'sciatica'.
There is a destructive process in the sacrum, which has displaced fragments of bone density. Their distribution suggests a soft tissue process with its centre of radius in the middle of the sacrum.

Illustrated cases

Discussion: - rare, slow growing tumor arising from remnants of the notochord in axial skeleton of middle aged adults; - most occur in midline at base of skull and in the sacrococcygeal area ...

six cases of clival chordoma. MRI is the best technique, but CT shows bone destruction. Signs include posterior extension, lobulated, "honeycomb" enhancement, "swollen bone", bone erosion.

Mature adult male with weakness in both legs. The view shows a myelogram after cervical injection of contrast, probably iodinated oil. This undocumented case in our museum dates from before the days of CT scanning. The contrast was introduced by insertion of a needle under fluoscopic control into the cervical theca...

Radiology case 331-3141 The usual plain film of a middle aged adult with back pain. Effectively an incidental finding.
There is a coarsening of the bone texture with relative preservation of vertical trabecula in the body of the third lumbar vertebra. There is spondylotic change between L4 and L5 with disc...

x-ray:
* slight loss of density of vertebral body
* vertically striped orientation of bone trabeculae ("corduroy cloth") which may extend into the pedicle
* occ. with posterior bulging
* cortical margins usually intact

Journal of Orthopaedic Surgery: 2005 13(3) 232 Review of Hong Kong experience with 12 patients. Conclusion: Surgical stabilization in selected patients provided pain relief and preserved ambulatory status before the deterioration of overall function. (full text)