J Korean Soc Spine Surg.  2020 Sep;27(3):109-114. 10.4184/jkss.2020.27.3.109.

Thoracic Chordoma in an Atypical Location Mimicking an Esophageal Adenocarcinoma - A Case Report -

Affiliations
  • 1Department of Orthopedic Surgery, Khoula Hospital, Oman
  • 2Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract


Objectives
To report a case of chordoma mimicking adenocarcinoma in a 52-year-old woman. Summary of Literature Review: Chordoma, a rare malignant tumor of primitive notochordal origin, accounts for 1-4% of all bone malignancies. Chordoma mimicking esophageal adenocarcinoma in the posterior mediastinum is unique.
Materials and Methods
A 52-year-old asymptomatic woman was referred to our center with an incidentally detected posterior mediastinal mass and no significant medical history. The mass was diagnosed on a routine medical screening by esophagogastroduodenoscopy and the patient was receiving yearly follow-up. An increase in size was noticed during the second year of follow-up on endoscopic ultrasonography and the patient was referred to the Department of Gastrointestinal Surgery of our hospital. This paper was written after receiving institutional review board (IRB) approval (KC20ZASI0214).
Results
En bloc resection was performed for the growing thoracic mass and pathologic findings confirmed it to be chordoma. A followup computed tomography examination was conducted at 8 months, as well as magnetic resonance imaging at 1 year, and there was no local recurrence.
Conclusions
Posterior mediastinal chordoma at the thoracic level is very rare. Furthermore, it is difficult to diagnose because its immunohistochemical characteristics mimic those of esophageal adenocarcinoma, meaning that it can be missed. Management is a challenge due to its anatomical location and additional local invasion. Therefore, a multidisciplinary approach is needed, including careful consultation with the patient to provide the optimal treatment for the best possible outcome.

Keyword

Chordoma; Mediastinum; Esophageal adenocarcinoma
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