Loehn Bridget, Walvekar Rohan R, Harton Anthony, Nuss Dan
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Skull Base. 2009 Sep;19(5):363-8. doi: 10.1055/s-0029-1220203.
This article reports an unusual presentation wherein the first evidence of distant failure from a locally controlled, recurrent skull base chordoma was a metastasis to the mandible. We present a case report from a tertiary-care academic skull base referral center and a review of literature. A 33-year-old woman with a locally recurrent spheno-occipital chordoma that was stabilized with multimodality therapy presented with a right mandibular mass. Immunohistochemical stains demonstrated the tumor cells staining positive for vimentin, cytokeratin, epithelial membrane antigen (EMA), and S100 consistent with metastatic chordoma. Positron emission tomography-computed tomography imaging further revealed widespread distant failure. Chordomas are rare tumors with only four previous reports of metastasis to the mandible. This is the first presentation of a mandibular metastasis from a spheno-occipital chordoma. We present a review of literature and summarize the demographic, clinical, pathological, treatment-related data, and discuss follow-up information from previous reports of metastatic chordomas to the mandible.
本文报道了一种不寻常的表现，即局部控制的复发性颅底脊索瘤远处转移的首个证据是转移至下颌骨。我们呈现了一份来自三级医疗学术颅底转诊中心的病例报告及文献综述。一名33岁女性，患有经多模式治疗稳定的局部复发性蝶枕脊索瘤，出现右侧下颌肿块。免疫组化染色显示肿瘤细胞波形蛋白、细胞角蛋白、上皮膜抗原（EMA）和S100染色呈阳性，符合转移性脊索瘤。正电子发射断层扫描 - 计算机断层扫描成像进一步显示广泛的远处转移。脊索瘤是罕见肿瘤，此前仅有4例转移至下颌骨的报道。这是蝶枕脊索瘤转移至下颌骨的首例报告。我们进行了文献综述，总结了人口统计学、临床、病理、治疗相关数据，并讨论了既往转移性脊索瘤至下颌骨报告的随访信息。
