title: Multifocal thoracic chordoma mimicking a paraganglioma.
abstract: Chordoma of thoracic vertebras is a very rare locally invasive neoplasm with low grade malignancy arising from embryonic notochordal remnants. Radical surgery remains the cornerstone of the treatment. We describe a case of multifocal T1-T2 chordoma, without bone and disc involvement, incidentally misdiagnosed as a paraganglioma, occurring in a 47-year-old male asymptomatic patient. Neoplasm was radically removed by an endocrine surgeon through a right extended cervicotomy. A preoperative reliable diagnosis of chordoma, as in the reported case, is often difficult. Radical surgery can provide a favorable outcome but, given the high rates of local recurrence of this neoplasm, a strict and careful follow-up is recommended. Although very rare, chordoma should be suggested in the differential diagnosis of the paravertebral cervical masses of unknown origin. Spine surgeon consultation and a FNB should be routinely included in the multidisciplinary preoperative work-up of these neoplasms.
authors.affiliation: Department of Anaesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambardella
authors.forename: Daniela
authors.initials: D
authors.lastname: Pasquali
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciancia
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.forename: Cristina Della
authors.initials: CD
authors.lastname: Pietra
authors.forename: Salvatore
authors.initials: S
authors.lastname: Napolitano
authors.forename: Antonietta
authors.initials: A
authors.lastname: Palazzo
authors.forename: Claudio
authors.initials: C
authors.lastname: Mauriello
authors.forename: Domenico
authors.initials: D
authors.lastname: Parmeggiani
authors.forename: Guido
authors.initials: G
authors.lastname: Pettinato
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Napolitano
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
mesh_terms: D044963:Biopsy, Fine-Needle; D002817:Chordoma / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000175:diagnosis*; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome