Some aspects of cervical chordoma.

This paper reviews 13 cases of chordoma in the cervical spine and base of the skull which have been seen at the Pack Medical Foundation over the past 25 years. Chordomas are dysonto genetic, malignant, slow-growing neoplasms that arise in remnants of the embryonic notochord. Concealed along the axial skeleton, these slow-growing tumors are usually well entrenched before they are accurately diagnosed. The majority of the chordomas of the spine occur in the sacroccygeal region. Of the 13 cases in the area of the cervical spine, 39% occurred in the region of the base of the skull and 61% in the area of the cervical spine. The treatment of the cervical tumors consisted of laminectomy to relieve the pressure on the cord and to remove as much of the neoplasm as possible. Some of the tumors at the base of the skull were nonresectable and were treated with radiotherapy. Radiotherapy was ultimately used in every case, either in combination with surgery or as a primary or subsequent method of management. The overall prognosis for palliation was fair but ineffective for cure.