A Metastatic Parachordoma Case

Parachordoma is a soft tissue tumor with a high risk of local recurrence. Despite the fact that parachordomas mostly have an indolent course, distant metastasis can be seen on rare occasion. We hereby report a case of a 28-year-old male who was initially diagnosed with parachordoma five years ago when he presented with a mass on his right shoulder. He suffered from local recurrence twice within the first two years after his surgery. Metastatic disease later presented itself with a mass in his left retro-orbital fossa. The patient underwent a partial surgical resection and the pathologic evaluation was reported as ‘’myoepithelial tumor metastasis’’. The patient’s systemic work up showed bilateral pulmonary metastatic nodules and metastasis in the right sacroiliac joint. After radiotherapy for the sacroiliac and left orbital mass, chemotherapy was initiated. The regimen consisted of ifosfamide, mesna and doxorubicin. Follow-up evaluation revealed a minimal decrease in size in the pulmonary nodules and the retro-orbital mass.  There was no 18-FDG uptake in the sacroiliac mass on PET-BT. In conclusion, surveillance carries importance due to the risk of metastasis for patients with parachordoma. Systemic chemotherapy consisting of doxorubicin and ifosfamide could be used successfully.