En bloc marginal excision of a multilevel cervical chordoma. Case report.
The purpose of this case report is to demonstrate that an en bloc resection with negative surgical margins can be successfully achieved in a case of a seemingly unresectable C-2 chordoma if appropriate preoperative staging and planning are performed. The management of chordomas is controversial and challenging because of their location and often large size at presentation. Because chordomas are malignant and will aggressively recur locally if intralesional resection is conducted, wide or true en bloc resection is generally recommended. The literature indicates, however, that surgeons are reluctant to perform wide or even marginal resections because of the lesion's complex surrounding anatomy and the risk of significant neurological compromise when a tumor abuts the dura mater or neural tissues. In this report the authors outline the successful en bloc resection of a large C1-3 chordoma and discuss the importance of preoperative staging and planning.
Bailey
Christopher S
CS
Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedics, University of British Columbia, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada.
Fisher
Charles G
CG
Boyd
Michael C
MC
Dvorak
Marcel F S
MF
D001707:Biopsy, Needle; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D002817:Chordoma / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009460:Neurologic Examination; D010027:Osteotomy; D010347:Patient Care Planning; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology; D012017:Referral and Consultation; D012086:Reoperation; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed