Chordoma is a rare type of slow-growing cancerous tumor that commonly occurs on the bones of lower spine or base of the skull, which affects nerves that control face and eyes movement and swallowing. Chordomas are considered sarcomas, cancers that arise in connective tissues including bones, cartilage and muscles.
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Cancers come from mutations in a cell’s DNA, causing it to acquire the ability to divide infinitely, invade other tissues, and to avoid destruction by the immune system. Chordomas are sporadic and develop at random during the course of one’s life. A very small fraction of chordoma occurence is hereditary or familial.
If you have a skull base chordoma, the most common symptoms that you will experience are related to pain or changes in nerve function such as:
- Neck pain
- Double vision
- Facial muscle paralysis
- Slur or speech changes
- Difficulty swallowing
Chordoma is diagnosed by obgaining special imaging such as MRI and CT scans to clearly show the extent of tumor. Focused MRIs of the pituitary region, sinuses, temporal bones or internal auditory canals may be indicated to obtain better anatomical detail of a chordoma. Other tests may also be needed prior to surgery such as angiography (typically now performed as a CT angiogram or an MR angiogram), visual field tests, an audiogram or hormonal tests.
Magnetic Resonance Imaging (MRI) – MRI shows the soft tissues of the body and gives clearer picture of the skull base and spine.
Computerized Tomography (CT Scan)- Combined CT scan and myleography produces image that clearly show both the bone structures of the spine and the nerve structures
Angiography – A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body.
Biopsy- Minimally invasive nature of fine needle aspiration biopsy may be required to confirm chrodoma diagnosis.
Each chordoma patient is unique. Factors that impact the course of treatment and outcome are patient’s overall health condition, age, gender, tumor location and size. The best treatment for chordoma is surgical removal. At ONE® Brain & Spine Center® your Southern California neurosurgeon, Robert Louis, MD, performs minimally invasive procedure to surgically remove the tumor.
For recurrent chordoma, a combination of follow-up surgery and radiation may be an option depending on where the tumor returns. Most chordoma patients require multiple surgeries over the course of several years.
Minimally Invasive Surgical Treatments
- Endoscopic Transsphenoidal Surgery- The endoscopic transsphenoidal surgical procedure uses a light called endoscope inserted into the nostril and sphenoid sinus to access and remove pituitary tumors. The term transsphenoidal literally means “through the sphenoid sinus.”