A Case of Chordoma Which Occurred at Cervical Spine

Abstract

We report a rare case of chordoma which occurred at cervical spine. A 84-year-old man had a numbness in upper extremities from 1986. Gradually he had difficulty of defecation, dysuria and gait disturbance. Plain X-rays of the cervical spine showed structural damage to the posterior side of the C4 body due to the tumor. Myelography demonstrated a complete block at C3-C4 level.
A tumor of the cervical spine was suspected. Then in February 1987 the tumor resection and replacement of a vertebral body with ceramic implant were carried out. After surgery, the gait ability of the patient improved quite well.
Pathological diagnosis obtained was the metastasis of parathyroid tumor. According to this diagnosis, resection of parathyroid was performed but there was no malignancy.
Because the gait disturbance appeared again, the second surgery was carried out to replace the implant in the end of 1988. The pathological diagnosis obtained this time was chordoma. Now the patient is ambulating quite well.
Chordoma is a rare tumor which arises from foetal notochordal rests. It accounts for about 0.8 percent of all primary bone tumors. It occurs mostly at the sacrococcygeal and cranial areas, but it is seldom found in the cervical spine. Generally 45-49 percent in the sacrococcygeal, 36-39 percent in the cranial, 14-18 percent in the spinal areas. Cervical chordoma presents formidable problems in diagnosis.