Riopel Céline, Michot Chantal
Service d'Anatomie Pathologique, Hôpital Ambroise Paré, AP-HP, 9, avenue Charles de Gaulle, 92104 Boulogne Cedex.
Ann Pathol. 2007 Feb;27(1):6-15. doi: 10.1016/s0242-6498(07)88679-2.
Chordoma is a rare bone tumor, believed to derive from notochordal rests, which generally arises at the two extremities of axial skeleton. We present a literature review on chordomas. Diagnosis has been greatly improved by MRI and immunohistochemistry. Conversely, complementary immunohistochemistry, cytometry and cytogenetic techniques have failed to improve prognosis evaluation. Radical surgery with free surgical margins is the most accurate curative treatment. Progress in radiotherapy should offer new therapeutic perspectives in the future. The recognition of new entities such as giant notochordal rest or hamartoma, and notochordal cells benign tumor, can lead to confusion since there is no consensus regarding their nature and whether or not they correspond to chordoma precursors. Prudence should be the rule in order to avoid overtreatment.
脊索瘤是一种罕见的骨肿瘤,被认为起源于脊索残余组织,通常发生于中轴骨骼的两端。我们对脊索瘤进行了文献综述。MRI和免疫组化极大地改善了诊断。相反,辅助免疫组化、细胞计数和细胞遗传学技术未能改善预后评估。具有手术切缘阴性的根治性手术是最确切的治愈性治疗方法。放射治疗的进展有望在未来提供新的治疗前景。对诸如巨大脊索残余或错构瘤以及脊索细胞良性肿瘤等新实体的认识可能会导致混淆,因为关于它们的性质以及它们是否对应于脊索瘤前体尚无共识。为避免过度治疗,应遵循谨慎原则。