title: A Parapharyngeal Soft Tissue Chordoma Presenting with Synchronous Cervical Lymph Node Metastasis: An Unusual Presentation.
abstract: A 63 year old male presented with a three month history of dysphagia, neck swelling and an oropharyngeal swelling on examination. Initial fine needle aspiration cytology and magnetic resonance imaging (done at a peripheral hospital) suggested a salivary gland neoplasm with lymph node metastasis. An infra-temporal approach was employed to excise the tumour mass and a modified radical neck dissection undertaken to remove the cervical metastasis. Histopathological examination with immunohistochemistry confirmed this to be a soft tissue chordoma. To the best of our knowledge, this is the first documented report of an extra-axial soft tissue chordoma presenting with synchronous metastatic disease. Though rare, this adds to the list of differential diagnoses for complex parapharyngeal lesions. A multidisciplinary approach between head and neck surgery, histopathology, radiology and sarcoma teams is paramount for arriving at the correct diagnosis and to deliver optimal treatment.
authors.affiliation: Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK. s.a.khurram@sheffield.ac.uk.
authors.forename: S A
authors.identifier: http://orcid.org/0000-0002-0378-9380
authors.initials: SA
authors.lastname: Khurram
authors.affiliation: Department of Otolaryngology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2JF, UK.
authors.forename: D
authors.initials: D
authors.lastname: Biswas
authors.affiliation: Department of Histopathology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2JF, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fernando
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000032:analysis; D002817:Chordoma / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: Chordoma; Head and neck; Metastasis; Paraharyngeal; Soft tissue