Chordoma: Site-Wise Predilections and Pathological Tenets.

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Chordomas are rare, slow-growing, locally invasive neoplasms originating from the notochordal remnants.
• They predominantly occur in the axial skeleton, including the skull base, spine, and sacrococcygeal region.
• Accurate diagnosis relies on integrated radiological, histopathological, and immunohistochemical criteria, with surgical resection aiming for negative margins.

Purpose of the Study:

• To analyze the clinico-pathological spectrum of chordoma cases.
• To investigate variations in clinical presentation and pathological features based on anatomical location.
• To contribute to the understanding of this rare tumor in a tertiary care setting in Northern India.

Main Methods:

• Retrospective analysis of 41 histopathologically confirmed chordoma cases from January 2013 to August 2023.
• Recording and review of clinico-radiological data and histopathological diagnoses by two pathologists.
• Statistical comparison of clinico-pathological parameters across different anatomical locations (spheno-occipital, sacrococcygeal, vertebral).

Main Results:

• A total of 41 chordomas were analyzed, with a mean age of 43.2 years and a male:female ratio of 1.2:1.
• Spheno-occipital chordomas were most frequent (27 cases), followed by sacrococcygeal (8) and vertebral (6). Pain was the most common symptom.
• Patient age (P=0.011) and tumor size (P=0.0004) showed statistically significant variations based on anatomical location.

Conclusions:

• Clinico-pathological parameters of chordomas exhibit significant variation depending on their anatomical location.
• Age and tumor size are key factors that differ significantly across anatomical sites.
• This study provides valuable insights into the clinico-radiopathological features of chordomas encountered in Northern India.