Chordoma

Cancer is always frightening, no matter where it occurs. One type of cancer that is particularly distressing is chordoma, a rare malignant bone tumor that forms in the spine or the base of the skull. More specifically, it’s a type of sarcoma, which is a broad group of cancers that begin in the bones and your soft (connective) tissues. A chordoma tumor usually grows slowly, often without symptoms at first, and then might cause symptoms for years before doctors find it. Chordoma can be fatal, but with early diagnosis and appropriate treatment, many chordoma patients can live for a decade or more and some can be cured. That’s why it is so crucial to find skilled surgeons with extensive experience treating chordomas like the first-class experts you’ll find at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.

OVERVIEW

Chordomas account for about 3 percent of all bone tumors and about 20 percent of primary spinal tumors. They are diagnosed in just 1 in 1 million people every year. There’s nothing that can be done to prevent developing chordoma. Most cases happen randomly. They develop in anyone at any age, but they are most likely to occur in adults aged 40 to 80. Men and people assigned male at birth are approximately 1.5 times as likely to have a chordoma as women and people assigned female at birth. However, chordomas, especially the types that appear at the bottom of the spine, affect more women than men. Skull base chordomas are more common in younger patients; spinal chordomas are more likely after age 50. It is possible to develop more than one chordoma tumor at a time, in different places along the spine.

WHAT IS A CHORDOMA?

Chordomas are complicated tumors to treat due to the involvement of critical structures such as the brainstem, spinal cord, and important nerves and arteries. They can also come back or recur after treatment — usually in the same place as the first tumor. This is called a local recurrence. In about 30 to 40 percent of patients, the tumor eventually spreads or metastasizes to other parts of the body, usually to the lungs. After it has recurred, it can cause death, typically due to tissue destruction in the spinal cord, or brainstem. Different segments of the spine correlate with different parts of the body, and so a chordoma’s effects depend on where along the spine it occurs:

• The skull base includes a bone called the clivus, where about a third of all chordomas develop. Tumors there affect cranial and facial nerves and can affect vision.
• The cervical spine starts just below the skull and ends just above the thoracic spine. Its nerves branch off to the arms and upper chest.
• The thoracic spine is the mid-back. Its nerves branch off to the abdomen and chest.
• The lumbar spine is the lower back. Its nerves branch off to the hips, knees, ankles, and toes.
• The sacrum is the base of the spine and below that is the coccyx. A chordoma in this area can affect the function of the legs, pelvis, bowel, and bladder.

TYPES OF CHORDOMA

The World Health Organization (WHO) recognizes three distinct types of chordoma based on what the cells look like under a microscope (their histology):

• Classic/conventional chordoma. This is the most common type (80-90% of all cases). It’s made up of a unique type of cell that looks “bubbly”.
• Chrondoid is a variant of this type. Under a microscope, it has certain features of a conventional chordoma and a chondrosarcoma, which is another type of cancer, but one that derives from cells that produce cartilage.
• Differentiated chordoma is the rarest (less than 5% of cases). It’s more aggressive, faster growing, and more likely to metastasize.

Read more about Chordoma on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a spine specialist today.