Multiple primary chordomas of the lung

Area of Science:

• Oncology
• Pulmonary Medicine
• Pathology

Background:

• Chordomas are rare malignant bone tumors typically arising from the axial skeleton.
• Primary pulmonary chordomas are exceptionally rare, with limited documented cases.

Observation:

• A 40-year-old male presented with multiple, bilateral, slow-growing pulmonary nodules detected over 14 years.
• Initial chest radiograph at age 26 noted an abnormality, but no further investigation occurred due to asymptomatic presentation.

Findings:

• Thoracoscopic resection and subsequent pathological examination confirmed the diagnosis of chordomas in two resected lung nodules.
• Comprehensive systemic examination revealed no other chordoma lesions, including the axial skeleton.
• The patient remains disease-free 38 months post-surgery, suggesting a favorable outcome for this rare presentation.

Implications:

• This case highlights the possibility of multiple primary pulmonary chordomas, a condition previously considered exceedingly rare.
• It underscores the importance of thorough diagnostic workup for persistent pulmonary nodules, even in asymptomatic individuals.
• Further research into the etiology and optimal management of primary pulmonary chordomas is warranted.