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DOI: 10.1055/s-0029-1220203
© Thieme Medical Publishers
Mandibular Metastasis from a Skull Base Chordoma: Report of a Case with Review of Literature
Publikationsverlauf
Publikationsdatum:
16. April 2009 (online)

ABSTRACT
This article reports an unusual presentation wherein the first evidence of distant failure from a locally controlled, recurrent skull base chordoma was a metastasis to the mandible. We present a case report from a tertiary-care academic skull base referral center and a review of literature. A 33-year-old woman with a locally recurrent spheno-occipital chordoma that was stabilized with multimodality therapy presented with a right mandibular mass. Immunohistochemical stains demonstrated the tumor cells staining positive for vimentin, cytokeratin, epithelial membrane antigen (EMA), and S100 consistent with metastatic chordoma. Positron emission tomography–computed tomography imaging further revealed widespread distant failure. Chordomas are rare tumors with only four previous reports of metastasis to the mandible. This is the first presentation of a mandibular metastasis from a spheno-occipital chordoma. We present a review of literature and summarize the demographic, clinical, pathological, treatment-related data, and discuss follow-up information from previous reports of metastatic chordomas to the mandible.
KEYWORDS
Chordoma - skull base tumor - mandibular metastasis - distant metastasis
REFERENCES
- 1 Erdem E, Angtuaco E C, Van Hemert R, Park J S, Al-Mefty O. Comprehensive review of intracranial chordoma. Radiographics. 2003; 23(4) 995-1009
- 2 Shugar J M, Som P M, Krespi Y P, Arnold L M, Som M L. Primary chordoma of the maxillary sinus. Laryngoscope. 1980; 90(11 Pt 1) 1825-1830
- 3 Mizerny B R, Kost K M. Chordoma of the cranial base: the McGill experience. J Otolaryngol. 1995; 24(1) 14-19
- 4 Heffelfinger M J, Dahlin D C, MacCarty C S, Beabout J W. Chordomas and cartilaginous tumors at the skull base. Cancer. 1973; 32(2) 410-420
- 5 Fischbein N J, Kaplan M J, Holliday R A, Dillon W P. Recurrence of clival chordoma along the surgical pathway. AJNR Am J Neuroradiol. 2000; 21(3) 578-583
- 6 Chambers P W, Schwinn C P. Chordoma. A clinicopathologic study of metastasis. Am J Clin Pathol. 1979; 72(5) 765-776
- 7 Schonegger K, Gelpi E, Prayer D et al.. Recurrent and metastatic clivus chordoma: systemic palliative therapy retards disease progression. Anticancer Drugs. 2005; 16(10) 1139-1143
- 8 Forsyth P A, Cascino T L, Shaw E G et al.. Intracranial chordomas: a clinicopathological and prognostic study of 51 cases. J Neurosurg. 1993; 78(5) 741-747
- 9 Gorsky M, Silverman Jr S, Greenspan D, Deluchi S, Merrell P. Metastatic chordoma to the mandible. Oral Surg Oral Med Oral Pathol. 1983; 55(6) 601-604
- 10 McMaster M L, Goldstein A M, Bromley C M, Ishibe N, Parry D M. Chordoma: incidence and survival patterns in the United States, 1973–1995. Cancer Causes Control. 2001; 12(1) 1-11
- 11 Meneghini F, Castellani A, Camelin N, Zanetti U. Metastatic chordoma to the mandibular condyle: an anterior surgical approach. J Oral Maxillofac Surg. 2002; 60(12) 1489-1493
- 12 Hirshberg A, Leibovich P, Buchner A. Metastatic tumors to the jawbones: analysis of 390 cases. J Oral Pathol Med. 1994; 23(8) 337-341
- 13 Slee R W, al-Hilli F, Abdul-Wahab A W. Secondary chordoma of the mandible. Br J Oral Maxillofac Surg. 1989; 27(4) 346-349
- 14 Kulamarva G, Wilbourn M, Anand R, Mourouzis C, Spedding A V, Brennan P A. Metastasising chordoma to the mandible from a rare vertebral site: the first reported case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(2) 240-242
Rohan R WalvekarM.D.
Assistant Professor, Department of Otolaryngology–Head Neck Surgery, LSU Health Sciences Center
533 Bolivar Street, Suite 566, New Orleans, LA 70112
eMail: rwalve@lsuhsc.edu