The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique.
CLINICAL PRESENTATION: A 60-year-old man presenting with memory loss underwent magnetic resonance imaging,
which revealed an intradural retroclival mass without bone involvement.
INTERVENTION: The patient underwent an endoscopic AZD6738 in vivo transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma.
CONCLUSION: Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only www.selleckchem.com/products/bay-57-1293.html if a regrowth of the remnant is seen during neuroradiological follow-up.”
“OBJECTIVE: High-dose, single-fraction radiotherapy, also known as radiosurgery, has theoretical advantages for the treatment of chordoma, which is considered resistant to conventional radiation therapy. Demonstration of biological effectiveness, as
indicated by pathological response of a chordoma specimen after such radiotherapy, has not previously been reported.
CLINICAL PRESENTATION: A 72-year-old man presented with lower back pain and was found to have an L3 vertebral mass. Open biopsy yielded chordoma. He was considered for en bloc resection, but definitive radiation therapy was preferred owing to medical
comorbidities and concern for field contamination from the previous biopsy.
INTERVENTION: The patient underwent single-fraction, high-dose, image-guided radiation therapy to the tumor. Two months later, he underwent kyphoplasty because of recurrent pain. A core biopsy performed at that time showed viable chordoma. Four months after treatment, he underwent B corpectomy because of symptoms of mechanical instability. Pathology now showed near-complete necrosis Selleck BTSA1 of the resected chordoma.
CONCLUSION: Preoperative, single-fraction radiotherapy for chordoma induced a near-complete pathological response in this patient. That the effect was seen at 4 months but not 2 months after treatment suggests a time-dependent effect. This case suggests a promising role for single-fraction, image-guided radiation therapy in the treatment of chordoma.”
“OBJECTIVE: To describe delayed migration of a coil loop after adjunctive balloon remodeling of an anterior communicating artery aneurysm.
METHODS: A 56-year-old man with a subarachnoid hemorrhage from a small anterior communicating artery aneurysm underwent successful coil embolization with adjunctive balloon remodeling.