gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Highly malignant sacral chordoma in an adolescent – case report

Hochmalignes sakrales Chordom bei einem jungen Erwachsenen – Fallbericht

Meeting Abstract

Suche in Medline nach

  • corresponding author S.A. König - Städtisches Klinikum Karlsruhe
  • M. Wenz - Städtisches Klinikum Karlsruhe
  • S. Müller - Städtisches Klinikum Karlsruhe
  • U. Spetzger - Städtisches Klinikum Karlsruhe

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 044

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc299.shtml

Veröffentlicht: 11. April 2007

© 2007 König et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Sacral chordomas are of low-level malignancy but show a high level of recurrence. Metastases occur in 10% of sacral chordomas, usually late and after multiple resections. Wide en-bloc resection with postoperative radiation is the treatment of choice. Recent studies investigate the value of particle beam therapy versus conventional photon radiotherapy. This report details the authors experience with a malignant sacral chordoma.

Methods: The authors report about a 35-year-old man with a sacral chordoma who underwent 4 surgeries, conventional radiation therapy, and 1 resection of a cervical spine metastasis.

Results: Despite aggressive therapy avoiding progression of the tumor was not succesful. 4 years after initial diagnosis multiple metastases, affecting liver, lung, heart and neck, were diagnosed, and the patient got into a terminal state of his disease.

Conclusions: The treatment of sacral chordoma is an arduous clinical undertaking that requires a multidisciplinary approach and attention to detail from the outset. Despite aggressive well-planned surgical management and adherence to strict surveillance protocols, frequent recurrence and the late onset of metastatic disease are to be expected in a substantial proportion of patients, especially those with a very large chordoma. Adequate surgical treatment results in substantial functional impairment and numerous complications; however, it does offer the possibility of a disease-free survival. We advocate an attempt at complete resection, when there is still a possibility of cure, and aggressive treatment of local recurrences.