Paravertebral High Cervical Chordoma A Case Report

• Published in: The neuroradiology journal Vol. 26; no. 2; pp. 227 - 232
• Main Authors: Elefante, A., Caranci, F., De Caro, M.L. Del Basso, Peca, C., Guadagno, E., Severino, R., Mariniello, G., Maiuri, F.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-04-2013
• Subjects: Adenocarcinoma - pathology; Aged; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - pathology; Chordoma - pathology; Cone-Beam Computed Tomography; Female; Humans; Keratins - metabolism; Magnetic Resonance Imaging; Spinal Neoplasms - pathology; cervical spine; chordoma; magnetic resonance
• ISSN: 1971-4009; 2385-1996
• DOI: 10.1177/197140091302600214

Spinal chordomas are more often located on the midline and are associated with marked destruction of the vertebral bodies. We report a rare case of large cervical (C2-C3) right lateral paravertebral chordoma extending into the spinal canal through a very enlarged intervertebral foramen. The tumor was initially diagnosed as a mucous adenocarcinoma on a percutaneous needle biopsy. However, the neuroradiological features, including the well-defined tumor margins, the regular and sclerosing lytic bone changes with regular enlargement of the intervertebral C2-C3 foramen, were in favor of a more slowly growing lesion, such as schwannoma or neurofibroma. At surgery a well-demarcated capsulated tumor involving the nerve root was partially resected. Histology was in favor of a low-grade chordoma (Ki-67/MIB-1<1%). Postoperative proton beam therapy was also performed. The differential neuroradiological diagnosis is discussed.