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[Chordoma. Diagnostic and therapeutic problems].

P R Pistorio¹, R Latino, A Graziano

¹Dipartimento di Chirurgia, Divisione di Chirurgia Generale III, Università degli Studi di Catania.

Annali Italiani Di Chirurgia

|February 28, 2002

Summary

Chordomas are rare, slow-growing tumors originating from the notochord. This case highlights a less invasive anterior transperitoneal approach for a sacral chordoma in an elderly patient.

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Area of Science:

Oncology
Neurosurgery
Pathology

Background:

Chordomas are rare, slow-growing tumors originating from notochordal remnants within vertebral bodies.
They often present with late clinical manifestations, local recurrence, and rare metastasis.
Surgical resection is the primary treatment, requiring individualized approaches (anterior, posterior, or combined).

Observation:

Videolaparoscopy has emerged as a minimally invasive option for anterior approaches without increased morbidity.
Chemotherapy is generally ineffective due to low tumor response.
Radiotherapy is primarily palliative, used when radical surgery is not feasible, to manage pain, and improve post-operative outcomes.

Findings:

The authors present a case of a symptomatic elderly female with a sacral chordoma.

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The patient underwent subtotal tumor resection via an anterior transperitoneal approach.

This less invasive strategy was chosen due to tumor extension, biological characteristics, and patient age.

Implications:

Minimally invasive surgical techniques, like the anterior transperitoneal approach, can be effective for sacral chordomas, even in elderly patients.
Individualized surgical planning is crucial for optimizing outcomes in chordoma treatment.
Further research into optimizing surgical access and adjuvant therapies for chordomas is warranted.