Surgical Excision of Clivus Chordoma with the Use of Coblator—A Case Report
Affiliation(s)
1 B.J. Medical College, Civil Hospital, Ahmedabad, India. 2 ENT Department, Civil Hospital, Ahmedabad, India.
1 B.J. Medical College, Civil Hospital, Ahmedabad, India. 2 ENT Department, Civil Hospital, Ahmedabad, India.
ABSTRACT
Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done; the patient was relieved of the symptoms and was clinically better.
Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done; the patient was relieved of the symptoms and was clinically better.
Cite this paper
Shah, S. , Gandh, R. , Brahmbahtt, H. and Viswakarma, R. (2015) Surgical Excision of Clivus Chordoma with the Use of Coblator—A Case Report. International Journal of Otolaryngology and Head & Neck Surgery, 4, 211-214. doi: 10.4236/ijohns.2015.43035.
Shah, S. , Gandh, R. , Brahmbahtt, H. and Viswakarma, R. (2015) Surgical Excision of Clivus Chordoma with the Use of Coblator—A Case Report. International Journal of Otolaryngology and Head & Neck Surgery, 4, 211-214. doi: 10.4236/ijohns.2015.43035.
References
[1] Adebayo, A., Clark, M. and Mansell, N.J. (2008) Cerebrospinal Fluid Rhinorrhea Secondary to Ecchordosis Physaliphora. Skull Base, 18, 395-400.
http://dx.doi.org/10.1055/s-0028-1087221 [2] Gardner, W.J. and Tuner, O. (1941) Cranial Chordoma: A Clinical and Pathologic Study. JAMA Surgery, 42, 411-425.
http://dx.doi.org/10.1001/archsurg.1941.01210080211013 [3] Jiang, W.H., Zhao, S.P., Xie, Z.H., Zhang, H., Zhang, J.Y. and Xiao, J.Y. (2009) Endoscopic Resection of Chordomas in Different Clival Regions. Acta Otolaryngologica, 129, 71-83.
http://dx.doi.org/10.1080/00016480801995404 [4] Kitai, R., Yoshida, K., Kubota, T., Sato, K., Handa, Y., Kasahara, K. and Nakajima, H. (2005) Clival Chordoma Manifesting as Nasal Bleeding. A Case Report. Neuroradiology, 47, 368-371.
http://dx.doi.org/10.1007/s00234-005-1367-7 [5] Koshiyama, H., Sakamoto, M., Fujiwara, K., Kim, Y.C., Teraura, T. and Koh, T. (1992) Chondroid Chordoma Presenting with Hypopituitarism. Internal Medicine, 31, 1366-1369.
http://dx.doi.org/10.2169/internalmedicine.31.1366 [6] Macdonald, R.L., Cusimano, M.D., Deck, J.H., Gullane, P.J. and Dolan, E.J. (1990) Cerebrospinal Fluid Fistula Secondary to Ecchordosis Physaliphora. Neurosurgery, 26, 515-519.
http://dx.doi.org/10.1227/00006123-199003000-00022 [7] Menezes, A.H., Gantz, B.J., Traynelis, V.C. and McCulloch, T.M. (1997) Cranial Base Chordomas. Clinical Neurosurgery, 44, 491-509. [8] Raffel, C., Wright, D.C., Gutin, P.H. and Wilson, C.B. (1985) Cranial Chordomas: Clinical Presentation and Results of Operative and Radiation Therapy in Twenty-Six Patients. [9] Weber, A.L., Liebsch, N.J., Sanchez, R. and Sweriduk Jr., S.T. (1994) Chordomas of the Skull Base: Radiologic and Clinical Evaluation. Neuroimaging Clinics of North America, 4, 515-527.
[1] Adebayo, A., Clark, M. and Mansell, N.J. (2008) Cerebrospinal Fluid Rhinorrhea Secondary to Ecchordosis Physaliphora. Skull Base, 18, 395-400.
http://dx.doi.org/10.1055/s-0028-1087221 [2] Gardner, W.J. and Tuner, O. (1941) Cranial Chordoma: A Clinical and Pathologic Study. JAMA Surgery, 42, 411-425.
http://dx.doi.org/10.1001/archsurg.1941.01210080211013 [3] Jiang, W.H., Zhao, S.P., Xie, Z.H., Zhang, H., Zhang, J.Y. and Xiao, J.Y. (2009) Endoscopic Resection of Chordomas in Different Clival Regions. Acta Otolaryngologica, 129, 71-83.
http://dx.doi.org/10.1080/00016480801995404 [4] Kitai, R., Yoshida, K., Kubota, T., Sato, K., Handa, Y., Kasahara, K. and Nakajima, H. (2005) Clival Chordoma Manifesting as Nasal Bleeding. A Case Report. Neuroradiology, 47, 368-371.
http://dx.doi.org/10.1007/s00234-005-1367-7 [5] Koshiyama, H., Sakamoto, M., Fujiwara, K., Kim, Y.C., Teraura, T. and Koh, T. (1992) Chondroid Chordoma Presenting with Hypopituitarism. Internal Medicine, 31, 1366-1369.
http://dx.doi.org/10.2169/internalmedicine.31.1366 [6] Macdonald, R.L., Cusimano, M.D., Deck, J.H., Gullane, P.J. and Dolan, E.J. (1990) Cerebrospinal Fluid Fistula Secondary to Ecchordosis Physaliphora. Neurosurgery, 26, 515-519.
http://dx.doi.org/10.1227/00006123-199003000-00022 [7] Menezes, A.H., Gantz, B.J., Traynelis, V.C. and McCulloch, T.M. (1997) Cranial Base Chordomas. Clinical Neurosurgery, 44, 491-509. [8] Raffel, C., Wright, D.C., Gutin, P.H. and Wilson, C.B. (1985) Cranial Chordomas: Clinical Presentation and Results of Operative and Radiation Therapy in Twenty-Six Patients. [9] Weber, A.L., Liebsch, N.J., Sanchez, R. and Sweriduk Jr., S.T. (1994) Chordomas of the Skull Base: Radiologic and Clinical Evaluation. Neuroimaging Clinics of North America, 4, 515-527.