A clinicopathologic review of 25 cases of chordoma (a pleomorphic and metastasizing neoplasm).

A clinicopathologic study of 25 cases of chordoma revealed that this tumor occurs principally in (68%), with a predominance for the sixth decade of life (seven patients--28%), and shows a predilection for the sacrococcygeal region (52%). The symptomatology was intimately related to the location of the tumor. Histologically, chordoma showed an extremely wide range in its cellular composition and pattern, not only from tumor to tumor, but also often in different portions of the same tumor. In addition to the large physaliferous cells in a lobular arrangement, large cells with apparently degenerating nuclei (ghost cells) were commonly seen; cells arranged in concentric spherical formations were observed in two cases, whereas small, round cells predominated in another case. A sarcomatous pattern was prominent in two cases. Large pink cells were frequently seen and in one case were arranged in epithelial-like columns. Whether these neoplastic components can be related to different degrees of tumor differentiation is difficult to establish. Histologic features of five cases in which metastasis occurred were compared to previously described metastasizing cases. These appear to be few reliable features helpful in suggesting the metastatic potential of this neoplasm.