Chordoma of Spine above Sacrum -Surgical Treatment in 2 Cases-

Chordomas are rare neoplasms which arise from ectopic remnants of the embryonic notochord. They occur primarily in the sacro-coccygeal region or in the spheno-occipctal clival synchondrosis. We report two chordoma cases at unusual sites of the cervical and lumbar spine.The first case was a 73-year-old male who complained of aphagia for the first time in October 1997. Spine neoplasm was suspected on MRI, and the patient was diagnosed with chordoma in the cervical spine as the result of histopathological inspection. The tumor recurred and led to tetraplagia in January 1998. Although another resection was carried out, he died from respiratory muscle paralysis in February 2000.The second case was a 64-year-old woman. She complained of right inferior limb pain in 1983. Spinal neoplasm was suspected, and the patient was diagnosed with chordoma in the lumber spine through pathological inspection. She underwent two operations. In the first operation, resection and anterior fusion were performed, and secondary posterior fusion was added to increase support of the lumber vertebra. The tumor has not recurred for 7 years postoperatively. Chordoma should be extracted completely in one piece, otherwise the prognosis will be poor.