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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2024; 09(02): e109-e112
DOI: 10.1055/s-0044-1791194
Case Report

Recurrent Axis Chordoma after Carbon ion Therapy Necessitating Reconstructive Surgery with Osteocutaneous Radial Forearm Free Flap: A Case Report

Toshiro Imai
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Koreyuki Kurosawa
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Masanobu Hayashi
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Ishi Shinyo
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Miki Shoji
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Toshimi Aizawa
2   Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
,
Yoshimichi Imai
1   Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Abstract

Chordomas originate from remnant tissue of the notochord during embryonic development, with a relatively low incidence rate. Furthermore, chordomas, being resistant to radiotherapy, are primarily treated by resection; however, in some cases, particularly in those that involve the skull base or upper cervical spine, chordomas are unresectable. In recent years, carbon ion/proton beam therapy has shown significant efficacy in such cases. However, it is not sufficiently curative and is commonly associated with recurrence. Moreover, there is no consensus regarding the treatment of recurrent cases, resulting in several uncertainties pertaining to it. Here, we present the case of a 55-year-old male patient with axial chordoma who experienced recurrence after carbon ion therapy and underwent tumor reduction surgery for a longer life span. Two months postoperatively, dehiscence was found in the posterior pharyngeal wall, probably due to heavy ion therapy. Salvage surgery was performed using an osteocutaneous radial forearm free flap, and the patient's postoperative course was uneventful.

Keywords

recurrent chordoma - axis chordoma - carbon ion therapy

Ethical Statement

Written informed consent was obtained from the patient for publication of this case report and accompanying images.




Publication History

Received: 27 June 2024

Accepted: 23 July 2024

Article published online:
26 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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