April - June 2005, Volume 1, Issue 2
Case Report
This Article
Services
Google Scholar
PubMed
Acta Endocrinologica (Buc)
Branisteanu DD, Galesanu C, Saviuc E, Lisnic N, Negru D, Bostaca T, Galesanu MR
One case of sellar and suprasellar chordoma
Acta Endo (Buc) 2005, 1 (2): 219-226doi: 10.4183/aeb.2005.219
We describe one case of sellar and suprasellar chordoma found in a 44 year old female, with bitemporal hemianopsia and secondary amenorrhea, submitted to transfrontal surgery and telecobaltotherapy. Chordomas are slow growing neoplasms arising from notochordal remnants of the axial skeleton. The second most common site for chordomas, after the sacrococcygeal region, is the base of the skull. Skull base chordomas commonly result in cranial nerve deficits, such as blurred vision, facial weakness and swallowing difficulty. Occasionally, chordomas localized in the hypothalamic or pituitary region may lead to pituitary stalk disjunction, pituitary insufficiency and diabetes insipidus. Studies show that early diagnosis, combined with aggressive surgical resection, offers the best chance for long-term survival. Although optimal treatment consists of wide excision with adjuvant radiotherapy, skull base chordomas are rarely amenable to complete surgical removal. Traditionally, postoperative irradiation is delivered to doses of 6000-6500 cGy; however this approach controls the chordoma only for a few years. Prognosis depends on the histological grade of the tumor, atypical chordomas showing the lowest survival rate.
Keywords: chordoma, pituitary
Correspondence: Dumitru D. Branisteanu, MD PhD, Clinic of Endocrinology, ?St. Spiridon? University Hospital, Independentei Str. 1, Iasi, Romania, Tel. 0232 213 226, Fax 0232 278 224, email dumitru_branisteanu@yahoo.com
References:
1. Watkins L, Khudados ES, Kaleoglu M, Revesz T, Sacares P, Crockard HA. Skull base chordomas: a review of 38 patients, 1958-88. Br J Neurosurg 1993; 7(3):241-248.
[CrossRef]
2. Schechter MM, Liebeskind AL, Azar-Kia B. Intracranial chordomas. Neuroradiology 1974; 8(2):67-82.
[CrossRef]
3. Haridas A, Ansari S, Afshar F. Chordoma presenting as pseudoprolactinoma. Br J Neurosurg 2003; 17(3):260-262.
[CrossRef]
4. Kakuno Y, Yamada T, Hirano H, Mori H, Narabayashi I. Chordoma in the sella turcica. Neurol Med Chir (Tokyo) 2002; 42(7):305-308.
[CrossRef]
5. Thodou E, Kontogeorgos G, Scheithauer BW, Lekka I, Tzanis S, Mariatos P, Laws ER Jr. Intrasellar chordomas mimicking pituitary adenoma. J Neurosurg 2000; 92(6):976-982.
[CrossRef]
6. Lee HJ, Kalnin AJ, Holodny AI, Schulder M, Grigorian A, Sharer LR. Hemorrhagic chondroid chordoma mimicking pituitary apoplexy. Neuroradiology 1998; 40(11):720-723.
[CrossRef]
7. Kikuchi K, Watanabe K. Huge sellar chordoma: CT demonstration. Comput Med Imaging Graph 1994; 18(5):385-390.
[CrossRef]
8. Pinzer T, Tellkamp H, Schaps P. Intracranial chordoma. Case report of a destructively growing chondroid chordoma in the area of the sella turcica. Zentralbl Neurochir 1993; 54(3):133-138.
9. Kagawa T, Takamura M, Moritake K, Tsutsumi A, Yamasaki T. A case of sellar chordoma mimicking a non-functioning pituitary adenoma with survival of more than 10 years. Noshuyo Byori 1993; 10(2):103-106.
10. de Cremoux P, Turpin G, Hamon P, de Gennes JL. Intrasellar chordoma. Sem Hop 1980 18-25; 56(43-44):1769-1773.
11. Johnsen DE, Woodruff WW, Allen IS, Cera PJ, Funkhouser GR, Coleman LL. MR imaging of the sellar and juxtasellar regions. Radiographics 1991; 11(5):727-758.
12. Kachhara R, Nair S, Gupta AK, Radhakrishnan VV, Bhattacharya RN. Infrasellar craniopharyngioma mimicking a clival chordoma: a case report. Neurol India 2002; 50(2):198-200.
13. Wanibuchi M, Uede T, Ishiguro M, Tatewaki K, Kurokawa Y, Yoshida Y. A case of suprasellar intradural chordoma. No Shinkei Geka 1994; 22(3):269-272.
14. Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurge
[CrossRef]
15. Wang RZ, Ren ZY, Su CB, Yang Y, Tao W, Ma WB, Yin J. Extended transsphenoidal approach to giant tumors in sellar and clival area. Zhonghua Yi Xue Za Zhi 2004; 84(20):1693-1697.
16. Zhang YZ, Wang CC, Gao XH, Liu PN, He Y, Piao MX. Clinical application of minimally invasive neuroendoscopic techniques. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2005; 27(1):22-25.
17. Krishnan S, Foote RL, Brown PD, Pollock BE, Link MJ, Garces YI. Radiosurgery for cranial base chordomas and chondrosarcomas. Neurosurgery 2005; 56(4):777-784
[CrossRef]
18. Radner H, Katenkamp D, Reifenberger G, Deckert M, Pietsch T, Wiestler OD. New developments in the pathology of skull base tumors. Virchows Arch 2001; 438(4):321-335.
[CrossRef]
19. Kakuno Y, Yamada T, Hirano H, Mori H, Narabayashi I. Chordoma in the sella turcica. Neurol Med Chir (Tokyo) 2002; 42(7):305-308.
[CrossRef]
20. Krengli M, Liebsch NJ, Hug EB, Orecchia R. Review of current protocols for protontherapy in USA. Tumori 1998; 84):209-216.
21. Sims E, Doughty D, Macaulay E, Royle N, Wraith C, Darlison R, Plowman PN. Stereotactically delivered cranial radiation therapy: a ten-year experience of linac-based radiosurgery in the UK. Clin Oncol (R Coll Radiol) 1999; 11(5):303-320.
[CrossRef]
Romanian Academy
The Publishing House of the Romanian Academy
