Recurrent chordoma of the palate occurring in the surgical pathway: a case report

We report a rare case of a female patient that developed a recurrence of a clival chordoma in the pathway of surgical access following prior resection. We review the world literature regarding surgical pathway recurrences. An 18-year-old female patient presented with a 4 cm x 3 cm mass in the midline of the hard palate. She had a history of a large clival chordoma resected via a transoral transpalatal approach 2 years previously. She was diagnosed as having a recurrence of the chordoma following implantation in the surgical pathway. She was treated with a transoral radical resection of the hard palate followed by a radial free forearm flap reconstruction. Chordomas are locally aggressive, slow growing tumors with a high local recurrence rate. A rare mechanism of treatment failure is recurrence along the pathway of surgical access. Only isolated cases of this phenomenon have been reported in the world literature. We review the world literature regarding surgical pathway recurrences.