Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy

Intratumoral hemorrhage/apoplexy in clival chordomas is extremely uncommon, with only 16 reported cases. The average age of patients was 46.2 years and slightly more than half were men. In cases published before 1990, all patients died from their disease without any intervention. Since then, 11 pati...

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Autores principales: Uysal, Ece, Cohen, Michael A, Abou-Al-Shaar, Hussam, Palmer, Cheryl, Couldwell, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635681/
https://www.ncbi.nlm.nih.gov/pubmed/34873527
http://dx.doi.org/10.7759/cureus.19187
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author Uysal, Ece
Cohen, Michael A
Abou-Al-Shaar, Hussam
Palmer, Cheryl
Couldwell, William
author_facet Uysal, Ece
Cohen, Michael A
Abou-Al-Shaar, Hussam
Palmer, Cheryl
Couldwell, William
author_sort Uysal, Ece
collection PubMed
description Intratumoral hemorrhage/apoplexy in clival chordomas is extremely uncommon, with only 16 reported cases. The average age of patients was 46.2 years and slightly more than half were men. In cases published before 1990, all patients died from their disease without any intervention. Since then, 11 patients have undergone resection by a variety of approaches and there have been no deaths. The diagnosis of skull base chordomas relies on a combination of clinical presentation and radiographic features related to the location and invasion of the tumor. Chordomas presenting with sudden-onset symptoms should alarm the surgeon of a possible hemorrhage. As an illustration of this presentation, we describe a 58-year-old woman who presented with acute-onset headache and cranial nerve deficits. Computed tomography and magnetic resonance imaging demonstrated a hemorrhagic clival lesion with cavernous sinus extension. The patient underwent transsphenoidal resection of the lesion that resulted in the resolution of her symptoms. Histopathological evaluation of the lesion was consistent with chordoma with acute hemorrhagic components. Although intratumoral hemorrhage is rarely detected in chordomas, it should be considered a differential diagnosis of such lesions because prompt recognition and treatment are critical for patient survival.
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spelling pubmed-86356812021-12-05 Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy Uysal, Ece Cohen, Michael A Abou-Al-Shaar, Hussam Palmer, Cheryl Couldwell, William Cureus Neurosurgery Intratumoral hemorrhage/apoplexy in clival chordomas is extremely uncommon, with only 16 reported cases. The average age of patients was 46.2 years and slightly more than half were men. In cases published before 1990, all patients died from their disease without any intervention. Since then, 11 patients have undergone resection by a variety of approaches and there have been no deaths. The diagnosis of skull base chordomas relies on a combination of clinical presentation and radiographic features related to the location and invasion of the tumor. Chordomas presenting with sudden-onset symptoms should alarm the surgeon of a possible hemorrhage. As an illustration of this presentation, we describe a 58-year-old woman who presented with acute-onset headache and cranial nerve deficits. Computed tomography and magnetic resonance imaging demonstrated a hemorrhagic clival lesion with cavernous sinus extension. The patient underwent transsphenoidal resection of the lesion that resulted in the resolution of her symptoms. Histopathological evaluation of the lesion was consistent with chordoma with acute hemorrhagic components. Although intratumoral hemorrhage is rarely detected in chordomas, it should be considered a differential diagnosis of such lesions because prompt recognition and treatment are critical for patient survival. Cureus 2021-11-01 /pmc/articles/PMC8635681/ /pubmed/34873527 http://dx.doi.org/10.7759/cureus.19187 Text en Copyright © 2021, Uysal et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Uysal, Ece
Cohen, Michael A
Abou-Al-Shaar, Hussam
Palmer, Cheryl
Couldwell, William
Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title_full Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title_fullStr Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title_full_unstemmed Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title_short Hemorrhagic Skull Base Chordoma Presenting As Chordoma Apoplexy
title_sort hemorrhagic skull base chordoma presenting as chordoma apoplexy
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635681/
https://www.ncbi.nlm.nih.gov/pubmed/34873527
http://dx.doi.org/10.7759/cureus.19187
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