Circumferential Surgical Management of a Cervical Chordoma: A Case Report and Review of the Literature

TL;DR

This case report describes the surgical treatment of a rare cervical chordoma tumor and highlights the importance of a multidisciplinary approach for effective management.

Contribution

The paper presents a successful circumferential surgical approach combined with radiotherapy for cervical chordoma, emphasizing functional recovery and disease control.

Findings

A staged circumferential surgical approach achieved tumor resection and spinal reconstruction.

The patient showed significant neurological recovery and regained independent ambulation.

Histopathology confirmed conventional chordoma with brachyury expression.

Abstract

Cervical chordomas are rare malignant tumors derived from notochordal remnants and represent a surgical challenge due to their locally aggressive behavior and proximity to vital neurovascular structures. We present the case of a 57-year-old man with progressive neurological decline over two months, characterized by weakness in all extremities and gait impairment. MRI demonstrated a lobulated extradural mass extending from C3 to C6 with vertebral body destruction and severe spinal cord compression. A staged circumferential surgical approach was performed. The first stage involved anterior corpectomy and tumor resection with reconstruction using a titanium cage and anterior plate, while the second stage consisted of posterior instrumentation for stabilization. Histopathological examination confirmed conventional chordoma with brachyury expression. Postoperatively, the patient showed marked neurological recovery, achieving independent ambulation at two months, and was referred for adjuvant radiotherapy.

This case illustrates the complexity of cervical chordoma management and emphasizes the importance of multidisciplinary strategies. Circumferential resection with reconstruction, combined with precision radiotherapy, offers an effective approach to improve functional outcomes and long-term disease control in this rare but formidable entity.

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