Chordoma
Definition and Presentation
A benign slow growing tumour of
the skeleton arising from remnants of the so-called notocord from
which the skeleton is formed. These tumours are most commonly found
in the lower spine or sacrum but the second most frequent location
is the skull base. Presenting symptoms such as headache, double
vision are the most common, followed by swallowing difficulties and
facial numbness or pain.
Diagnosis
MRI and CT are important for
diagnosis but the final differentiation from chondrosarcoma and
other tumours is made by microscopic examination of a surgical
specimen (biopsy).
Treatment
The treatment of choice is surgical resection. These tumours are
notorious for recurring even many years following what was believed
to be a total resection. Due to the difficult location in the
centre of the skull base they are also often difficult to remove
radically. They are considered to be more radio-resistant than
chondrosarcomas. Gamma Knife surgery should therefore be a very
attractive post-operative adjunctive treatment. Positive
experiences from this combined therapy have been reported but the
numbers of patients treated is still low.
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20 months post |