title: Multicentric chordoma:  a case report and review of the literature.
abstract: BACKGROUND
  Chordomas are relatively rare tumors that arise from the neuraxis. Most often, chordomas are single lesions that metastasize late. There have been very few cases of chordomas arising from multiple foci along the neuraxis. Here, we present a case of a multicentric chordoma.
  
  
  METHODS
  The patient presented with pain in her right neck and soreness in her right shoulder that she had experienced for about 2.5 years that she attributed to a muscle strain. She experienced worsening of her symptoms, which prompted her to seek medical care. The patient underwent an occiput-to-C6 posterolateral fusion with autograft and an occiput-to-C6 posterior segmental instrumentation, along with decompression of the spinal cord. One month after the initial surgery, the patient underwent a second surgery. The C2 and C3 vertebral bodies were completely resected, and a C1-C4 anterior fusion was then carried out. A C5 vertebrectomy and C4-C6 fusion were also performed at this time. The patient then received proton beam radiation to the entire affected area.
  
  
  CONCLUSIONS
  Recent studies have suggested that chordomas arise from benign notochordal tumors. We suggest that our patient suffered from multicentric chordomas with possible benign notochordal tumors. Although benign notochordal tumors do not require surgical resection, the possibility of transformation to a malignant lesion requires close follow-up.
authors.affiliation: Department of Neurosurgery, Hennepin County Medical Center, Minneapolis, Minnesota, USA. gross348@umn.edu
authors.forename: Andrew
authors.initials: A
authors.lastname: Grossbach
authors.forename: Praveen
authors.initials: P
authors.lastname: Baimeedi
authors.forename: William
authors.initials: W
authors.lastname: McDonald
authors.forename: Thomas
authors.initials: T
authors.lastname: Bergman
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery; D002817:Chordoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D005326:Fetal Proteins / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007633:Keratins / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009418:S100 Proteins / Q000378:metabolism; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D020825:T-Box Domain Proteins / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism; D000098908:Brachyury Protein
chemical_list: D005326:Fetal Proteins; D007633:Keratins; D009418:S100 Proteins; D020825:T-Box Domain Proteins; D014746:Vimentin; D000098908:Brachyury Protein