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[A Case of Primary Intrasellar Chondroid Chordoma].
No Shinkei Geka. 2019 Aug; 47(8):901-907.NS

Abstract

OBJECTIVES

Intracranial chordomas are thought to arise from remnants of the notochord and usually occur at the parasellar region. We present a case of a primary intrasellar chondroid chordoma in a patient who was initially diagnosed with a pituitary adenoma.

CASE

A 77-year-old woman had a history of two surgeries for a tumor in the sella turcica(17 months after the 1st surgery). On initial MRI, the intrasellar mass showed low signal intensity on T1WI, very high signal intensity on T2WI, and inhomogeneous enhancement. On bone reconstructive CT, the sellar floor was thin, and no abnormalities were observed at the top of the clivus. Transsphenoidal surgery was performed. The pathological diagnosis was pituitary adenoma in both cases. Seventy-two months after the 1st(31 months after the 2nd)surgery, she developed right-sided oculomotor and abducent nerve palsies again. Since recurrence occurred during the relatively short period, the surgical specimens obtained from the 1st and 2nd surgeries were reexamined. Reexamination of the previously obtained specimen demonstrated areas of chondroid tissue that were embedded in a mucoid stroma and tumor cells that were composed of round or pleomorphic nuclei with vacuolated cytoplasm(physaliphorus cells)that were compatible with chondroid chordoma. The third surgery was performed. Postoperatively, her symptoms improved, and cyber knife therapy was administered for the residual part of the tumor.

CONCLUSIONS

Although intrasellar chondroid chordomas are extremely rare, they should be considered in the differential diagnosis of tumors located in the sella turcica.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Sakakibara Y
Division of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.
Taguchi Y
No affiliation info available
Nakamura H
No affiliation info available
Onodera H
No affiliation info available
Wakui D
No affiliation info available
Ikeda T
No affiliation info available
Aida Y
No affiliation info available

MeSH

AdenomaAgedChordomaDiagnosis, DifferentialFemaleHumansNeoplasm Recurrence, LocalPituitary NeoplasmsSella Turcica

Pub Type(s)

Case Reports
Journal Article

Language

jpn

PubMed ID

31477634

Citation

Sakakibara, Yohtaro, et al. "[A Case of Primary Intrasellar Chondroid Chordoma]." No Shinkei Geka. Neurological Surgery, vol. 47, no. 8, 2019, pp. 901-907.
Sakakibara Y, Taguchi Y, Nakamura H, et al. [A Case of Primary Intrasellar Chondroid Chordoma]. No Shinkei Geka. 2019;47(8):901-907.
Sakakibara, Y., Taguchi, Y., Nakamura, H., Onodera, H., Wakui, D., Ikeda, T., & Aida, Y. (2019). [A Case of Primary Intrasellar Chondroid Chordoma]. No Shinkei Geka. Neurological Surgery, 47(8), 901-907. https://doi.org/10.11477/mf.1436204042
Sakakibara Y, et al. [A Case of Primary Intrasellar Chondroid Chordoma]. No Shinkei Geka. 2019;47(8):901-907. PubMed PMID: 31477634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A Case of Primary Intrasellar Chondroid Chordoma]. AU - Sakakibara,Yohtaro, AU - Taguchi,Yoshio, AU - Nakamura,Homare, AU - Onodera,Hidetaka, AU - Wakui,Daisuke, AU - Ikeda,Tetsuya, AU - Aida,Yoshio, PY - 2019/9/4/entrez PY - 2019/9/4/pubmed PY - 2019/10/29/medline SP - 901 EP - 907 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 47 IS - 8 N2 - OBJECTIVES: Intracranial chordomas are thought to arise from remnants of the notochord and usually occur at the parasellar region. We present a case of a primary intrasellar chondroid chordoma in a patient who was initially diagnosed with a pituitary adenoma. CASE: A 77-year-old woman had a history of two surgeries for a tumor in the sella turcica(17 months after the 1st surgery). On initial MRI, the intrasellar mass showed low signal intensity on T1WI, very high signal intensity on T2WI, and inhomogeneous enhancement. On bone reconstructive CT, the sellar floor was thin, and no abnormalities were observed at the top of the clivus. Transsphenoidal surgery was performed. The pathological diagnosis was pituitary adenoma in both cases. Seventy-two months after the 1st(31 months after the 2nd)surgery, she developed right-sided oculomotor and abducent nerve palsies again. Since recurrence occurred during the relatively short period, the surgical specimens obtained from the 1st and 2nd surgeries were reexamined. Reexamination of the previously obtained specimen demonstrated areas of chondroid tissue that were embedded in a mucoid stroma and tumor cells that were composed of round or pleomorphic nuclei with vacuolated cytoplasm(physaliphorus cells)that were compatible with chondroid chordoma. The third surgery was performed. Postoperatively, her symptoms improved, and cyber knife therapy was administered for the residual part of the tumor. CONCLUSIONS: Although intrasellar chondroid chordomas are extremely rare, they should be considered in the differential diagnosis of tumors located in the sella turcica. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/31477634/[A_Case_of_Primary_Intrasellar_Chondroid_Chordoma]_ DB - PRIME DP - Unbound Medicine ER -