Extra Axial Chordoma of the Distal Tibia: A Case Report

Area of Science:

• Orthopedic Oncology
• Skeletal Radiology
• Tumor Pathology

Background:

• Chordomas are rare malignant bone tumors originating from notochordal remnants.
• Extra-axial chordomas, particularly in the distal tibia, are exceptionally uncommon.
• This case involves a 32-year-old female with a distal tibial chordoma exhibiting specific radiological and pathological features.

Purpose of the Study:

• To report a rare case of extra-axial chordoma in the distal tibia.
• To detail the clinical presentation, diagnostic investigations, and management of this rare tumor.
• To contribute to the literature by documenting this unusual presentation and reviewing similar cases.

Main Methods:

• Case report of a 32-year-old woman with a distal tibial tumor.
• Detailed description of clinical findings, imaging studies (MRI, CT), and histopathological analysis.
• Immunohistochemical analysis for brachyury expression was performed.
• A comprehensive literature review of reported tibial chordoma cases was conducted.

Main Results:

• Diagnosis of an extra-axial chordoma in the distal tibia with posterior intracortical epicenter.
• Tumor showed intramedullary and soft tissue extension.
• Positive expression of brachyury on immunohistochemical analysis, confirming chordoma.
• The patient's clinical course, treatment, and follow-up were documented.

Conclusions:

• This case represents a rare occurrence of distal tibial chordoma.
• Increased awareness among musculoskeletal oncologists is crucial for timely diagnosis and management.
• Documentation of such rare cases aids in understanding the tumor's behavior and improving patient outcomes.