Chordoma - sacrum

Case contributed by A.Prof Frank Gaillard

Patient Data

Age: 85 years
Gender: Male
MRI

Heterogenous mass arising from the sacral vertebra, seen as predominantly hypointense on T1 and hyperintense on T2 with vivid contrast enhancement. Multiple non-enhancing hypointense areas represent matrix calcifications.

Case Discussion

The patient went on to have a biopsy. 

Histology

The sections show strands and clusters of atypical epithelioid cells within a myxoid matrix. The tumour cells have oval to round, occasionally spindled, hyperchromatic nuclei with occasional larger nuclei with irregular contours. The cells have a moderate amount of vacuolated eosinophilic cytoplasm. Well developed physaliferous cells are not found. An occasional mitotic figure is found. There is no necrosis. Overt cartilaginous or osteoid tissue is not found.

By immunohistochemistry, the tumour cells are strongly positive for keratin. They are positive for S100 and EMA. They are negative for PSA.

FINAL DIAGNOSIS: chordoma

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Case information

rID: 6177
Published: 2nd May 2009
Last edited: 29th Apr 2018
Tag: spine
Inclusion in quiz mode: Included

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