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Lower Cervical Chordomas: A Case Report and Differential Diagnosis
Yosita Muenkaew1, Artit Jinawath2, Wichit Cheewaruangroj1
1Department of Otolaryngology-Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
Background:
Chordomas are rare tumors that arise from notochord remnants and are typically located in the axial skeleton. Chordomas arising in the lower cervical spine are rare.
Method:
We report a case of a 79-year-old man who presented with a lump on the left side of his neck, indicating an unusual presentation of a chordoma in the lower cervical region. This report describes the clinical, radiological, and histological results of this patient who sought medical attention for a left-sided neck mass. Additional diagnostic tests, including immunohistochemistry and biopsy, confirmed the existence of a chordoma affecting the lower cervical region.
Result:
The precision of a diagnosis of cervical chordoma hinges on imaging study results and confirmation provided by histological examination, typically through biopsy and immunohistochemistry. The primary treatment for cervical chordoma is the surgical resection. Adjunctive therapies, such as radiation therapy and, in some cases, chemotherapy, may be used to manage residual disease or recurrent tumors.
Conclusion:
This case emphasizes the rarity of lower cervical chordomas, which present as a neck mass and are a diagnostic dilemma. Total excision is complex and relies on combining multiple disciplines including imaging, immunohistochemistry, and adjunct radiation therapy. Long-term follow-up and early detection are key to better outcomes and reduced recurrence.
