1
|
Pena-Burgos EM, Torena Lerchundi N, Fuentes-Sánchez J, Tapia-Viñe M, Fernández-Baíllo N, Pozo-Kreilinger JJ. Notochordal cell derived lesions: a 55-year casuistic analysis of 50 cases with radiologic-pathologic correlation in a tertiary referral hospital, and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024:10.1007/s00586-024-08419-y. [PMID: 39048841 DOI: 10.1007/s00586-024-08419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/17/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
Distinct lesions are derived from notochordal cells (NCDL), ranging from benign to malignant ones. This study presents fifty NCDL cases diagnosed in a tertiary hospital of reference from the past 55 years: forty-two conventional chordomas, including one chondroid chordoma subtype, four benign notochordal cell tumors (BNCT), two conventional chordomas with BNCT foci, and two dedifferentiated chordomas. All patients were adults. Three BNCT were incidentally diagnosed, and one case presented local pain. Chordomas began with local pain and/or neurological symptoms. BNCT were well-defined intraosseous lesions, hypointense on T1-weighted images (WI) and hyperintense on T2-WI, without enhancement in the contrast. Conventional chordomas, including its chondroid subtype, were lobulated masses with cortical disruption and soft tissue extension, hypointense on T1-WI and hyperintense on T2-WI, with variable contrast enhancement. BNCT were histologically composed of solid sheets of vacuolated cells with clear cytoplasm and round and central nuclei. No atypia, lobular growth pattern, myxoid matrix, or bone infiltration were seen. Conventional chordomas were histologically composed of physaliphorous cells in a myxoid stroma with lobulated and infiltrating growth patterns. Observational follow-up using radiological controls was decided on for the BNCT cases. None of these cases presented local recurrence or metastasis. En-bloc resection and adjuvant radiotherapy were selected for sacral and vertebral chordoma cases. Sixteen patients died due to tumor-related factors; twenty-eight presented local recurrence, and four developed distant metastases. New therapeutic options are being studied for chordoma cases. Clinical, radiological, and histopathological data are necessary to properly diagnose and follow up of NCDL.
Collapse
Affiliation(s)
- Eva Manuela Pena-Burgos
- Pathology Department, La Paz University Hospital, Paseo de la Castellana, 261, Madrid, 28046, Spain.
| | | | - Jorge Fuentes-Sánchez
- Orthopaedic Surgery and Traumatology Department, La Paz University Hospital, Madrid, Spain
| | - Mar Tapia-Viñe
- Radiology Department, La Paz University Hospital, Madrid, Spain
| | | | | |
Collapse
|
2
|
Grabovska D, Strumfa I, Ositis J, Liepniece-Karele I, Balodis A. Benign Notochordal Cell Tumours: Case Report and Literature Review. Diagnostics (Basel) 2024; 14:1330. [PMID: 39001221 PMCID: PMC11240483 DOI: 10.3390/diagnostics14131330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Benign notochordal cell tumours (BNCTs) represent a rare entity within the spectrum of bone neoplasms, which typically arise in the axial skeleton. Although these tumours are often benign, their diagnosis and management pose significant challenges due to their histological similarity to more aggressive lesions, such as chordomas. Understanding of the clinical behaviour, diagnostic nuances, and optimal management strategies for BNCTs continues to evolve. CASE REPORT Benign notochordal cell tumours of the vertebra are usually asymptomatic and identified on imaging and should be distinguished from chordomas, which has a more aggressive clinical course. This report describes a 15-year-old girl with lumbosacral pain and a diagnosis of a benign notochordal cell tumour, which affects a large part of the S1 vertebra in the lumbar spine, highlighting the diagnostic challenges encountered, the role of radiological and histological investigations, and the ultimate determination of the benign nature of the tumour. CONCLUSIONS This report highlights the approach taken for the diagnosis of a benign notochordal cell tumour of the vertebra and the importance of excluding differential diagnoses. By exploring the intricacies of this case, we contribute to the growing body of literature surrounding BNCTs, with the aim of improving clinical awareness and management strategies for this uncommon bone tumour.
Collapse
Affiliation(s)
- Dagnija Grabovska
- Faculty of Residency, University of Latvia, LV-1586 Riga, Latvia
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
| | - Ilze Strumfa
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
| | - Janis Ositis
- Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia
| | - Inta Liepniece-Karele
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
| | - Arturs Balodis
- Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia
| |
Collapse
|
3
|
Samargandi R, de Pinieux G, Amelot A, Le Nail LR. Chordoma concurrent with benign notochordal cell tumor of the mobile spine. Should the chordoma part be biopsied? - A stepwise approach for management. Neurochirurgie 2023; 69:101488. [PMID: 37696448 DOI: 10.1016/j.neuchi.2023.101488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/05/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023]
Abstract
Some evidence suggests that benign notochordal tumors (BNCTs) could be a potential precursor of chordoma. We present an educational rare case of lumbar vertebral BNCTs concomitant with a destructive lesion not reachable on biopsy but thought to be chordoma. We present a stepwise approach for management of these difficult entities based on radiological features.
Collapse
Affiliation(s)
- Ramy Samargandi
- Service de Chirurgie Orthopédique et traumatologie, CHRU de Tours, Tours, France; Orthopedic Surgery Department, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
| | | | - Aymeric Amelot
- Service de Neurochirurgie, CHRU de Tours, Tours, France.
| | - Louis-Romée Le Nail
- Service de Chirurgie Orthopédique et traumatologie, CHRU de Tours, Tours, France; CNRS ERL 7001 LNOx: Leukemic Niche & redOx metabolism - EA 7501 GICC - Université de Tours, France.
| |
Collapse
|
4
|
Prather KY, Shi HH, McKinney KA, Dunn IF. Chronic cerebrospinal fluid rhinorrhea as an initial presentation of chordoma: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 5:CASE2347. [PMID: 37014007 PMCID: PMC10555546 DOI: 10.3171/case2347] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Skull base chordomas are typically extradural and present with cranial nerve deficits, headache, and visual disturbances. Clival chordoma involving the dura and presenting as a spontaneous cerebrospinal fluid (CSF) leak is extremely rare and can be mistaken for other skull base lesions. Here the authors present a case of chordoma with an unusual presentation. OBSERVATIONS A 43-year-old female who presented with clear nasal drainage was diagnosed with CSF rhinorrhea secondary to a clival defect previously thought to be ecchordosis physaliphora. The patient subsequently developed bacterial meningitis and underwent endoscopic, endonasal, transclival gross-total resection of the lesion with repair of the dural defect. Pathology revealed brachyury-positive chordoma. She received adjuvant proton beam radiotherapy and has remained stable for 2 years. LESSONS Spontaneous CSF rhinorrhea can occur as a rare primary presentation of clival chordoma, requiring careful radiological interpretation and a high index of suspicion for diagnosis. Chordoma cannot be reliably differentiated from benign notochordal lesions based on imaging alone; thus, intraoperative exploration and immunohistochemistry play key roles. Clival lesions presenting with CSF rhinorrhea should undergo prompt resection to facilitate diagnosis and prevent complications. Future studies on connections between chordoma and benign notochordal lesions may help to establish management guidelines.
Collapse
Affiliation(s)
- Kiana Y. Prather
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and
| | - Helen H. Shi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and
| | - Kibwei A. McKinney
- Department of Otolaryngology–Head and Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ian F. Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and
| |
Collapse
|
5
|
Salle H, Durand S, Durand K, Bourthoumieu S, Lemnos L, Robert S, Pollet J, Passeri T, Khalil W, Froelich S, Adle-Biassette H, Labrousse F. Comparative analysis of histopathological parameters, genome-wide copy number alterations, and variants in genes involved in cell cycle regulation in chordomas of the skull base and sacrum. J Neuropathol Exp Neurol 2023; 82:312-323. [PMID: 36779322 DOI: 10.1093/jnen/nlad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Chordomas are rare tumors of the axial skeleton that are refractory to conventional therapy. Few studies have compared the morphological and molecular characteristics of chordomas according to the skull base and sacral locations. Histopathological data and changes revealed by array comparative genomic hybridization (CGH) and next-generation sequencing (NGS) of cell cycle regulation genes were analyzed for 28 skull base (SBCs) and 15 sacral (SC) chordomas. All cases were conventional chordomas. SBCs were significantly more frequent in patients aged <40 years and SCs predominated in patients aged >60 years. Mitotic indices ≥2 mitoses/10 high-power fields were correlated with high degrees of nuclear atypia and Ki67 labeling indices ≥6%. We identified 321 genomic positions, and copy number variation losses were more frequent than gain. Moreover, we report a panel of 85 genetic variants of cell cycle genes and the presence of molecular clusters for chordoma as well in CGH as in NGS. These new data strengthen the view that the chordoma should not be considered as a single molecular entity.
Collapse
Affiliation(s)
- Henri Salle
- Department of Neurosurgery, CHU Limoges, Limoges, France
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | - Stéphanie Durand
- Inserm, CAPTuR, GEIST Institute, University of Limoges, Limoges, France
| | - Karine Durand
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | | | - Leslie Lemnos
- Department of Neurosurgery, CHU Limoges, Limoges, France
| | - Sandrine Robert
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | - Justine Pollet
- Plateforme Technique BISCEm US 42 INSERM/UMS 2015 CNRS, Limoges, France
| | - Thibault Passeri
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - Wassim Khalil
- Department of Neurosurgery, CHU Limoges, Limoges, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - Homa Adle-Biassette
- AP-HP, Hôpital Lariboisière, Service Anatomie Pathologique and Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - François Labrousse
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
- Department of Pathology, Limoges University Hospital, Limoges, France
| |
Collapse
|
6
|
Murphey MD, Minn MJ, Contreras AL, Koeller KK, Shih RY, Inwards CY, Yamaguchi T. Imaging of spinal chordoma and benign notochordal cell tumor (BNCT) with radiologic pathologic correlation. Skeletal Radiol 2023; 52:349-363. [PMID: 36063190 DOI: 10.1007/s00256-022-04158-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 02/02/2023]
Abstract
Benign notochordal cell tumor (BNCT) and chordoma are neoplasms of notochordal differentiation. BNCT represents notochordal rests, commonly an incidental lesion present in the spine in 19% of cadaveric specimens. BNCTs are often radiographically occult. CT of BNCT frequently reveals patchy sclerosis between areas of maintained underlying trabeculae. BNCT demonstrates marrow replacement on T1-weighted MR images with high signal intensity on T2-weighting. BNCTs are frequently smaller than 35 mm and lack significant enhancement, bone destruction, cortical permeation, or soft tissue components. Biopsy or surgical resection of BNCT is usually not warranted, although imaging surveillance may be indicated. Chordoma is a rare low-grade locally aggressive malignancy representing 1-4% of primary malignant bone tumors. Chordoma is most frequent between the ages of 50-60 years with a male predilection. Clinical symptoms, while nonspecific and location dependent, include back pain, numbness, myelopathy, and bowel/bladder incontinence. Unfortunately, lesions are often large at presentation owing to diagnosis delay. Imaging of chordoma shows variable mixtures of bone destruction and sclerosis, calcification (50-70% at CT) and large soft tissue components. MR imaging of chordoma reveals multilobulated areas of marrow replacement on T1-weighting and high signal intensity on T2-weighting reflecting the myxoid component within the lesion and areas of hemorrhage seen histologically. Treatment of chordoma is primarily surgical with prognosis related to resection extent. Unfortunately, complete resection is often not possible (21-75%) resulting in high local recurrence incidence (19-75%) and a 5-year survival rate of 45-86%. This article reviews and illustrates the clinical characteristics, pathologic features, imaging appearance spectrum, treatment, and prognosis of BNCT and spinal chordoma.
Collapse
Affiliation(s)
- Mark D Murphey
- Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA. .,Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA. .,Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD, 20889, USA.
| | - Matthew J Minn
- Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA.,Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD, 20889, USA.,Department of Radiology, Scripps Green Hospital, 10666 N. Torrey Pines Road, La Jolla, CA, 92037, USA
| | | | - Kelly K Koeller
- Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA.,Department of Radiology, Head and Neck Cancer Center, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Robert Y Shih
- Musculoskeletal Imaging and Neuroradiology, ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA.,Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD, 20889, USA
| | - Carrie Y Inwards
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Takehiko Yamaguchi
- Department of Pathology, Nikko Medical Center, Dokkyo Medical University, 632 Takatoku, Nikko, Tochigi, 321-2593, Japan
| |
Collapse
|
7
|
Pattamapaspong N, Peh WCG. Benign incidental do-not-touch bone lesions. Br J Radiol 2023; 96:20211334. [PMID: 35604667 PMCID: PMC9975527 DOI: 10.1259/bjr.20211334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023] Open
Abstract
Benign bone lesions may occasionally be incidentally detected on radiographs and are also increasingly found on CT or MRI performed for other clinical indications. Although mostly asymptomatic or associated with minor symptoms, these lesions may simulate true pathological lesions, causing problems in diagnosis. For instance, asymptomatic benign bone lesions can be misinterpreted as metastasis when incidentally encountered in a patient with known cancer. Recognising these entities as "do-not-touch" lesions helps avoid unnecessary further investigation or harmful intervention. In this review, we highlight three groups of bone incidentalomas found in adults, namely: osteolytic lesions, osteoblastic lesions, and bone protuberances. We aim to review the key imaging features of selected common and less common conditions in these three groups, so as to help radiologists confidently identify these benign do-not-touch lesions and to distinguish them from more sinister pathological lesions.
Collapse
Affiliation(s)
- Nuttaya Pattamapaspong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wilfred CG Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Yishun Central, Singapore
| |
Collapse
|
8
|
Sidorin VS, Efimov AV, Strelkina KA, Sokolova TV, Orlov AY, Zabrodskaya YM. [Chordoma as a neurosurgical pathology]. Arkh Patol 2022; 84:24-31. [PMID: 35639840 DOI: 10.17116/patol20228403124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Assess the significance of chordoma as a neurosurgical pathology, taking into account the latest edition of the WHO classification of soft tissues and bone tumors (2020). MATERIAL AND METHODS An analysis of 28 chordomas was carried out. All chordomas were histologically verified, including using immunohistochemical markers of notochordal differentiation (S100, EMA, keratin, brachiuria protein). RESULTS Patients with chordomas accounted for 0.25% of the total number of neurosurgical patients. The vast majority (27) of chordomas had a cranio-vertebral localization. Sacral localization (S3-S5) of the tumor was detected in 1 patient. In 4 (15%) cases, operations were performed for the recurrence of chordoma. The tumors tended to grow into the structures of the skull, overgrown the vessels and nerves, and compress the adjacent brain structures. This was manifested by pain syndrome, neurological symptoms, impaired liquorodynamics. According to histopathological criteria, 27 (96%) cases of tumors were classified as conventional (usual) chordoma type, among them 7 corresponded to the chondroid subtype of the chordoma. In 1 case (4%), a dedifferentiated chordoma was detected. CONCLUSION Chordoma, due to its axial localization, naturally involves adjacent structures of the nervous system, has clinically significant neuropathological manifestations, and often provides direct indications for a special neurosurgical approach. This requires its consideration not only as a bone, but also as a neurosurgical oncological pathology, along with other non-meningothelial (mesenchymal) tumors of the CNS.
Collapse
Affiliation(s)
- V S Sidorin
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - A V Efimov
- I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - K A Strelkina
- I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - T V Sokolova
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - A Yu Orlov
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Yu M Zabrodskaya
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| |
Collapse
|
9
|
Abstract
This review provides an overview of the spectrum of tumors showing notochordal differentiation. This spectrum encompasses benign entities that are mostly discovered incidentally on imaging, reported as benign notochordal cell tumor, usually not requiring surgical intervention; slowly growing and histologically low-grade tumors referred to as conventional chordoma but associated with a significant metastatic potential and mortality; and more aggressive disease represented by histologically higher-grade tumors including dedifferentiated chordoma, a high-grade biphasic tumor characterized by a conventional chordoma juxtaposed to a high-grade sarcoma, usually with a spindle or pleomorphic cell morphology, and associated with a poor prognosis and poorly differentiated chordoma.
Collapse
Affiliation(s)
- Roberto Tirabosco
- Department of Histopathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
| | - Paul O'Donnell
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK
| | - Adrienne M Flanagan
- Department of Histopathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK; UCL Cancer Institute, University College London, 72 Huntley Street, London WC1 E 6DD, UK
| |
Collapse
|
10
|
Zhang K, Liu Z, Wang Z, Zhou Z, Shao X, Hua X, Mao H, Yang H, Ren K, Chen K. Long Non-Coding RNA MDFIC-7 Promotes Chordoma Progression Through Modulating the miR-525-5p/ARF6 Axis. Front Oncol 2021; 11:743718. [PMID: 34621682 PMCID: PMC8491581 DOI: 10.3389/fonc.2021.743718] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Background Chordoma, an extremely rare malignant tumor, remains difficult to be cured because of its strong local invasiveness and high recurrence rate. Long non-coding RNAs (lncRNAs) have been demonstrated to play multiple roles in various cancers. The purpose of this study was to investigate the modulatory function of lncRNA MDFIC-7 in chordoma and to elucidate its underlying mechanisms. Methods Quantitative real-time polymerase chain reaction was performed to detect the expression of lncRNA MDFIC-7 in tumor tissues and adjacent nontumorous tissues collected from 15 chordoma patients, as well as in chordoma cell lines. Gene silencing and overexpression experiments were carried out by RNA interference and lentiviral transduction. The effect of lncRNA MDFIC-7 on the proliferation of chordoma cells was evaluated by cell counting kit-8 assay, colony formation assay and xenograft tumor experiments. RNA immunoprecipitation and dual luciferase reporter assays were conducted to evaluate the binding between lncRNA MDFIC-7 and miRNA-525-5p and the interaction between miR-525-5p and the 3′ untranslated region of ADP-ribosylation factor 6 (ARF6) mRNA. The glycolytic capacity and mitochondrial function of chordoma cells were measured by the Seahorse Bioscience XF96 Extracellular Flux Analyzer. Results The expression of lncRNA MDFIC-7 was higher in chordoma tumor tissues than in adjacent non-tumor tissues. Downregulation of lncRNA MDFIC-7 reduced colony formation and cell proliferation in chordoma cells and decreased xenograft tumor growth in a nude mouse model. Moreover, lncRNA MDFIC-7 knockdown attenuated the Warburg effect in chordoma cells and xenograft tumors. LncRNA MDFIC-7 knockdown elevated miR-525-5p levels and decreased ARF6 expressions. Overexpression of ARF6 reversed the inhibitory effect of lncRNA MDFIC-7 knockdown on cell proliferation and the Warburg effect in chordoma cells and xenograft tumors. Mechanistically, lncRNA MDFIC-7, as a molecular sponge of miR-525-5p, negatively regulated miR-525-5p expression and promoted the gene expression of ARF6, a miR-525-5p target. Conclusion Our findings demonstrate that lncRNA MDFIC-7 acts as a molecular sponge to competitively bind to miR-525-5p and promote expression of ARF6. The lncRNA MDFIC-7/miR-525-5p/ARF6 axis regulates chordoma progression and the Warburg effect in chordoma, suggesting that lncRNA MDFIC-7 and miR-525-5p could be promising therapeutic targets for the treatment of chordoma.
Collapse
Affiliation(s)
- Kai Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zixiang Liu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhidong Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhangzhe Zhou
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaofeng Shao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xi Hua
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haiqing Mao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huilin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ke Ren
- Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Chengdu, China.,School of Laboratory Medicine/Sichuan Provincial Engineering Laboratory for Prevention and Control Technology of Veterinary Drug Residue in Animal-Origin Food, Chengdu Medical College, Chengdu, China
| | - Kangwu Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
11
|
Chordoma: 18F-FDG PET/CT and MRI imaging features. Skeletal Radiol 2021; 50:1657-1666. [PMID: 33521875 DOI: 10.1007/s00256-021-03723-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Examine the 18F-FDG PET/CT and MRI imaging characteristics of chordoma. MATERIALS AND METHODS Biopsy-proven chordoma with a pre-therapy 18F-FDG PET/CT from 2001 through 2019 in patients > 18 years old were retrospectively reviewed. Multiple PET/CT and MRI imaging parameters were assessed. RESULTS A total of 23 chordoma patients were included (16 M, 7 F; average age of 60.1 ± 13.0 years) with comparative MRI available in 22 cases. This included 13 sacrococcygeal, 9 mobile spine, and one clival lesions. On 18F-FDG PET/CT, chordomas demonstrated an average SUVmax of 5.8 ± 3.7, average metabolic tumor volume (MTV) of 160.2 ± 263.8 cm3, and average total lesion glycolysis (TLG) of 542.6 ± 1210 g. All demonstrated heterogeneous FDG activity. On MRI, chordomas were predominantly T2 hyperintense (22/22) and T1 isointense (18/22), contained small foci of T1 hyperintensity (17/22), and demonstrated heterogeneous enhancement (14/20). There were no statistically significant associations found between 18F-FDG PET/CT and MRI imaging features. There was no relationship of SUVmax (p = 0.53), MTV (p = 0.47), TLG (p = 0.48), maximal dimension (p = 0.92), or volume (p = 0.45) to the development of recurrent or metastatic disease which occurred in 6/22 patients over a mean follow-up duration of 4.1 ± 2.0 years. CONCLUSION On 18F-FDG PET/CT imaging, chordomas demonstrate moderate, heterogeneous FDG uptake. Predominant T2 hyperintensity and small foci of internal increased T1 signal are common on MRI. The inherent FDG avidity of chordomas suggests that 18F-FDG PET/CT may be a useful modality for staging, evaluating treatment response, and assessing for recurrent or metastatic disease.
Collapse
|
12
|
Abstract
CONTEXT.— Chordomas are uncommon malignant neoplasms with notochordal differentiation encountered by neuropathologists, bone/soft tissue pathologists, and general surgical pathologists. These lesions most commonly arise in the axial skeleton. Optimal therapy typically involves complete surgical resection, which is often technically difficult owing to the anatomic location, leading to a high rate of recurrence. Lesions have been generally resistant to radiation and chemotherapy; however, experimental studies involving targeted therapy and immunotherapy are currently underway. OBJECTIVE.— To summarize the clinical and pathologic findings of the various types of chordoma (conventional chordoma, dedifferentiated chordoma, and poorly differentiated chordoma), the differential diagnosis, and recent advances in molecular pathogenesis and therapeutic modalities that are reliant on accurate diagnosis. DATA SOURCES.— Literature review based on PubMed searches containing the term "chordoma" that address novel targeted and immunomodulatory therapeutic modalities; ongoing clinical trials involved in treating chordoma with novel therapeutic modalities identified through the Chordoma Foundation and ClinicalTrials.gov; and the authors' practice experience combined with various authoritative texts concerning the subject. CONCLUSIONS.— Chordoma is a clinically and histologically unique malignant neoplasm, and numerous diagnostic considerations must be excluded to establish the correct diagnosis. Treatment options have largely been centered on surgical excision with marginal results; however, novel therapeutic options including targeted therapy and immunotherapy are promising means to improve prognosis.
Collapse
Affiliation(s)
- Veronica Ulici
- From the Department of Pathology and Laboratory Medicine, Rhode Island Hospital, The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Jesse Hart
- From the Department of Pathology and Laboratory Medicine, Rhode Island Hospital, The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| |
Collapse
|
13
|
Sambri A, Fiore M, Giannini C, Pipola V, Zucchini R, Aparisi Gomez MP, Musa Aguiar P, Gasbarrini A, De Paolis M. Primary Tumors of the Sacrum: Imaging Findings. Curr Med Imaging 2021; 18:170-186. [PMID: 33982654 DOI: 10.2174/1573405617666210512011923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/22/2022]
Abstract
The diagnosis of sacral neoplasms is often delayed because they tend to remain clinically silent for a long time. Imaging is useful at all stages of managing sacral bone tumors: from the detection of the neoplasm to the long-term follow-up. Radiographs are recommended as the modality of choice to begin the imaging workup of a patient with known or suspected sacral pathology. More sensitive examinations such as computerized tomography (CT), magnetic resonance (MRI), or scintigraphy are often necessary. The morphological features of the lesions on CT and MRI help to orientate the diagnosis. Although some imaging characteristics are helpful to limit the differential diagnosis, an imaging-guided biopsy is often ultimately required to establish a specific diagnosis. Imaging is of paramount importance even in the long-term follow-up in order to assess any residual tumor when surgical resection is incomplete, to assess the efficacy of adjuvant chemotherapy and radiotherapy, and to detect recurrence.
Collapse
Affiliation(s)
- Andrea Sambri
- University of Bologna, Bologna, Italy.,IRCCS Azienda Ospedaliero Universitaria Policlinico di Sant’Orsola, Bologna, Italy
| | | | | | | | | | - Maria Pilar Aparisi Gomez
- Department of Radiology, Auckland City Hospital; 2 Park Road, Grafton, 1023 Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre; Calle Valle de la Ballestera, 59, 46015 Valencia, Spain
| | - Paula Musa Aguiar
- Serdil, Clinica de Radiologia e Diagnóstico por Imagem; R. São Luís, 96 - Santana, Porto Alegre - RS, 90620-170. Brazil
| | | | | |
Collapse
|
14
|
D'Ortenzio R, Tolhurst S, Harvey M, Ghag R, Heran MK. The CT guided transoral approach: A biopsy technique for a poorly differentiated chordoma in a 5 year old. J Radiol Case Rep 2021; 15:1-8. [PMID: 34267865 DOI: 10.3941/jrcr.v15i3.4208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mass lesions presenting at the craniocervical junction often present a unique challenge due to the complex anatomic arrangement limiting access for tissue diagnosis. The transoral approach has predominantly been used for percutaneous vertebroplasty of high cervical vertebrae with limited literature describing image guided biopsy for bony lesions in this region in the pediatric patient. We describe a technique of computed tomography guided transoral biopsy of a poorly differentiated chordoma located at the C1-C2 level in a 5-year-old child, and review this diagnosis.
Collapse
Affiliation(s)
- Robert D'Ortenzio
- Department of Radiology, Vancouver General Hospital, Vancouver, Canada
| | - Stefano Tolhurst
- Department of Radiology, Vancouver General Hospital, Vancouver, Canada
| | - Melissa Harvey
- Department of Pediatrics, BC Children's Hospital, Vancouver, Canada
| | - Ravi Ghag
- Department of Orthopaedics, BC Children's Hospital, Vancouver, Canada
| | - Manraj Ks Heran
- Department of Radiology, BC Children's Hospital, Vancouver, Canada
| |
Collapse
|
15
|
Barber SM, Sadrameli SS, Lee JJ, Fridley JS, Teh BS, Oyelese AA, Telfeian AE, Gokaslan ZL. Chordoma-Current Understanding and Modern Treatment Paradigms. J Clin Med 2021; 10:jcm10051054. [PMID: 33806339 PMCID: PMC7961966 DOI: 10.3390/jcm10051054] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/23/2022] Open
Abstract
Chordoma is a low-grade notochordal tumor of the skull base, mobile spine and sacrum which behaves malignantly and confers a poor prognosis despite indolent growth patterns. These tumors often present late in the disease course, tend to encapsulate adjacent neurovascular anatomy, seed resection cavities, recur locally and respond poorly to radiotherapy and conventional chemotherapy, all of which make chordomas challenging to treat. Extent of surgical resection and adequacy of surgical margins are the most important prognostic factors and thus patients with chordoma should be cared for by a highly experienced, multi-disciplinary surgical team in a quaternary center. Ongoing research into the molecular pathophysiology of chordoma has led to the discovery of several pathways that may serve as potential targets for molecular therapy, including a multitude of receptor tyrosine kinases (e.g., platelet-derived growth factor receptor [PDGFR], epidermal growth factor receptor [EGFR]), downstream cascades (e.g., phosphoinositide 3-kinase [PI3K]/protein kinase B [Akt]/mechanistic target of rapamycin [mTOR]), brachyury—a transcription factor expressed ubiquitously in chordoma but not in other tissues—and the fibroblast growth factor [FGF]/mitogen-activated protein kinase kinase [MEK]/extracellular signal-regulated kinase [ERK] pathway. In this review article, the pathophysiology, diagnosis and modern treatment paradigms of chordoma will be discussed with an emphasis on the ongoing research and advances in the field that may lead to improved outcomes for patients with this challenging disease.
Collapse
Affiliation(s)
- Sean M. Barber
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, TX 77030, USA; (S.M.B.); (S.S.S.); (J.J.L.)
| | - Saeed S. Sadrameli
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, TX 77030, USA; (S.M.B.); (S.S.S.); (J.J.L.)
| | - Jonathan J. Lee
- Department of Neurosurgery, Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, TX 77030, USA; (S.M.B.); (S.S.S.); (J.J.L.)
| | - Jared S. Fridley
- Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA; (J.S.F.); (A.A.O.); (A.E.T.)
| | - Bin S. Teh
- Department of Radiation Oncology, Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, TX 77030, USA;
| | - Adetokunbo A. Oyelese
- Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA; (J.S.F.); (A.A.O.); (A.E.T.)
| | - Albert E. Telfeian
- Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA; (J.S.F.); (A.A.O.); (A.E.T.)
| | - Ziya L. Gokaslan
- Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA; (J.S.F.); (A.A.O.); (A.E.T.)
- Correspondence: ; Tel.: +1-(401)-793-9132
| |
Collapse
|
16
|
Ball S, Dash A, Igid HP, Thein KZ, Sharma U, Tijani L. Extra-axial Chordoma Masquerading as Lung Cancer. Clin Lung Cancer 2021; 22:e658. [PMID: 33745862 DOI: 10.1016/j.cllc.2021.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Somedeb Ball
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
| | - Akshar Dash
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Henry P Igid
- Comprehensive Cancer Centers of Nevada, Las Vegas, NV
| | - Kyaw Z Thein
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Upama Sharma
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Lukman Tijani
- Division of Hematology and Medical Oncology, Texas Tech University Health Sciences Center, Lubbock, TX
| |
Collapse
|
17
|
Peris-Celda M, Salgado-Lopez L, Inwards CY, Raghunathan A, Carr CM, Janus JR, Stokken JK, Van Gompel JJ. Benign notochordal cell tumor of the clivus with chordoma component: report of 2 cases. J Neurosurg 2020; 133:1355-1359. [PMID: 31518983 DOI: 10.3171/2019.6.jns19529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/13/2019] [Indexed: 11/06/2022]
Abstract
Benign notochordal cell tumors (BNCTs) are considered to be benign intraosseous lesions of notochord origin; however, recent spine studies have suggested the possibility that some chordomas arise from BNCTs. Here, the authors describe two cases demonstrating histological features of BNCT and concomitant chordoma involving the clivus, which, to the best of the authors' knowledge, have not been previously documented at this anatomical site.An 18-year-old female presented with an incidentally discovered clival mass. Magnetic resonance imaging revealed a 2.8-cm nonenhancing lesion in the upper clivus that was T2 hyperintense and T1 hypointense. She underwent an uneventful endoscopic transsphenoidal resection. Histologically, the tumor demonstrated areas of classic chordoma and a distinct intraosseous BNCT component. The patient completed adjuvant radiation therapy. Follow-up showed no recurrence at 18 months.A 39-year-old male presented with an incidentally discovered 2.8-cm clival lesion. The nonenhancing mass was T2 hyperintense and T1 hypointense. Surgical removal of the lesion was performed through an endoscopic transsphenoidal approach. Histological analysis revealed areas of BNCT with typical features of chordoma. Follow-up did not demonstrate recurrence at 4 years.These cases document histologically concomitant BNCT and chordoma involving the clivus, suggesting that the BNCT component may be a precursor of chordoma.
Collapse
Affiliation(s)
- Maria Peris-Celda
- Departments of1Neurosurgery
- 2Department of Neurosurgery, Albany Medical Center, Albany, New York
| | | | | | | | | | - Jeffrey R Janus
- 5Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota; and
| | | | - Jamie J Van Gompel
- Departments of1Neurosurgery
- 5Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota; and
| |
Collapse
|
18
|
Li L, Lv G, Wang B, Ma H. Long Noncoding RNA LINC00525 Promotes the Aggressive Phenotype of Chordoma Through Acting as a microRNA-505-3p Sponge and Consequently Raising HMGB1 Expression. Onco Targets Ther 2020; 13:9015-9027. [PMID: 32982292 PMCID: PMC7490091 DOI: 10.2147/ott.s268678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022] Open
Abstract
Purposes Long intergenic non-protein coding RNA 525 (LINC00525), a long noncoding RNA, has been implicated in the carcinogenesis and progression of many human cancer types. However, the detailed roles of LINC00525 in chordoma and the underlying mechanisms are not fully understood. Here, we aimed to determine whether LINC00525 could modulate the oncogenicity of chordoma cells and to elucidate in detail the molecular events underlying these tumor-promoting activities. Methods Reverse-transcription quantitative polymerase chain reactions were performed to assess LINC00525 expression in chordoma. The effects of LINC00525 silencing on chordoma cell proliferation, apoptosis, migration, and invasiveness in vitro and tumor growth in vivo were respectively tested using CCK-8 assay, flow cytometry, migration and invasion assays, and xenograft experiments. Results High LINC00525 expression levels were detected in chordoma tissues. The proliferative, migratory, and invasive abilities of chordoma cells in vitro and their tumor growth in vivo were suppressed by the LINC00525 knockdown, whereas apoptosis was induced by it. Mechanistically, LINC00525 acted as a molecular sponge of microRNA-505-3p (miR-505-3p) and upregulated the expression of high mobility group box 1 (HMGB1), which is directly targeted by miR-505-3p. Rescue assays indicated that increasing the output of miR-505-3p-HMGB1 axis attenuated the effects of LINC00525 depletion on chordoma cells. Conclusion LINC00525, a pro-oncogenic long noncoding RNA, promotes chordoma progression by regulating the miR-505-3p-HMGB1 axis. The LINC00525-miR-505-3p-HMGB1 pathway may be a novel therapeutic target in chordoma.
Collapse
Affiliation(s)
- Lei Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Guohua Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China
| | - Hong Ma
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China
| |
Collapse
|
19
|
Zhu GG, Ramirez D, Chen W, Lu C, Wang L, Frosina D, Jungbluth A, Ntiamoah P, Nafa K, Boland PJ, Hameed MR. Chromosome 3p loss of heterozygosity and reduced expression of H3K36me3 correlate with longer relapse-free survival in sacral conventional chordoma. Hum Pathol 2020; 104:73-83. [PMID: 32795465 DOI: 10.1016/j.humpath.2020.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/26/2022]
Abstract
Conventional chordoma is a rare slow-growing malignant tumor of notochordal origin primarily arising at the base of the skull and sacrococcygeal bones. Chordoma may arise from its benign counterpart, benign notochordal cell tumors, and can also undergo dedifferentiation progressing into dedifferentiated chordoma. No study has directly compared the genomic alterations among these tumors comprising a morphologic continuum. Our prior study identified frequent chromosome 3p loss of heterozygosity and minimal deleted regions on chromosome 3 encompassing SETD2, encoding a histone methyltransferase involved in histone H3 lysine 36 trimethylation (H3K36me3). In the present study, we expanded our study to include 65 sacral conventional chordoma cases, 3 benign notochordal cell tumor cases, and 2 dedifferentiated chordoma cases using single nucleotide polymorphism (SNP) array, targeted next-generation sequencing analysis, and immunohistochemistry. We performed immunohistochemical analysis of histone, H3K36me3, and investigated whether there is any association between the clinical behavior and recurrent chromosome or aneuploidy or H3K36me3 protein expression. We found that there is increased genomic instability from benign notochordal cell tumor to conventional chordoma to dedifferentiated chordoma. The highly recurrent genomic aberration, chromosome 3p loss of heterozygosity (occurred in 70% of conventional chordomas), is correlated with longer relapse-free survival, but not with overall survival or metastasis-free survival in sacral chordoma. Chordomas demonstrate variable patterns and levels of H3K36me3 expression, and reduced expression of H3K36me3 showed marginally significant correlation with longer relapse-free survival. Copy number alterations in the genes encoding the H3K36me3 methylation transferase complex and demethylase may account for the altered H3K36me3 expression levels.
Collapse
Affiliation(s)
- Guo Gord Zhu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA; Department of Pathology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, 08003, USA
| | - Daniel Ramirez
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA; Department of Pathology, Northwell Health, Great Neck, NY, 11021, USA
| | - Wen Chen
- Department of Pathology, Washington DC VA Medical Center, Washington, DC, 20422, USA
| | - Chao Lu
- Department of Genetics & Development, Columbia University Medical Center, New York, NY, 10032, USA
| | - Lu Wang
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Denise Frosina
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Achim Jungbluth
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Peter Ntiamoah
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Khedoudja Nafa
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Patrick J Boland
- Orthopaedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Meera R Hameed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
| |
Collapse
|
20
|
Ozair MZ, Shah PP, Mathios D, Lim M, Moss NS. New Prospects for Molecular Targets for Chordomas. Neurosurg Clin N Am 2020; 31:289-300. [PMID: 32147018 DOI: 10.1016/j.nec.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chordomas are malignant, highly recurrent tumors of the midline skeleton that arise from the remnants of the notochord. The development of systemic therapy is critically important to ultimately managing this tumor. Several ongoing trials are attempting to use molecular targeted therapies for mutated pathways in recurrent and advanced chordomas and have shown promise. In addition, immunotherapies, including brachyury-directed vaccination and checkpoint inhibition, have also been attempted with encouraging results. This article discusses the major pathways that have been implicated in the pathogenesis of chordoma with an emphasis on molecular vulnerabilities that future therapies are attempting to exploit.
Collapse
Affiliation(s)
- Mohammad Zeeshan Ozair
- Laboratory of Stem Cell Biology and Molecular Embryology, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
| | - Pavan Pinkesh Shah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Dimitrios Mathios
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Michael Lim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Nelson S Moss
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
21
|
Usher I, Flanagan AM, Choi D. Systematic Review of Clinical, Radiologic, and Histologic Features of Benign Notochordal Cell Tumors: Implications for Patient Management. World Neurosurg 2019; 130:13-23. [PMID: 31421435 DOI: 10.1016/j.wneu.2019.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are no absolute defining criteria for benign notochordal cell tumors; the diagnosis is usually based on small size and the absence of aggressive features. Therefore, by definition, the diagnosis is subjective and usually determined by multidisciplinary consensus. A benign notochordal cell tumor should not grow during surveillance, and this may be used to confirm the diagnosis, but is a tautologic definition. Diagnostic ambiguity leads to uncertainty in management. If a tumor is a small chordoma then early surgery is likely to provide a better outcome. However, unnecessary treatment of a benign tumor may incur unjustified risk. OBJECTIVE To propose clearer guidelines for the definition and management of benign notochordal tumors. METHODS We performed a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) review of the reported definitions for benign notochordal tumors and their management. RESULTS The accepted features of benign notochordal tumors vary considerably: a typical tumor may be diagnosed in the absence of neurology, radiologically well-corticated bony margins, size <35 mm, no enhancement with contrast, no soft tissue extension, no dural penetration, no progression on scans, histologic absence of extracellular myxoid matrix, and low Ki67 index. If these criteria are fulfilled, it is reasonable to use radiologic surveillance in the first instance. Biopsy may be offered depending on the relative risks of performing the biopsy, or if there are atypical features. CONCLUSIONS We suggest a clearer definition for a benign notochordal tumor and a management algorithm that incorporates a level of diagnostic uncertainty.
Collapse
Affiliation(s)
- Inga Usher
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London.
| | - Adrienne M Flanagan
- Department of Histopathology, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| | - David Choi
- Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London
| |
Collapse
|
22
|
Sayyid SK, Wong PK, Read W, Monson DK, Umpierrez M, Gonzalez F, Kakarala A, Singer AD. The clincoradiologic spectrum of notochordal derived masses. Clin Imaging 2019; 56:124-134. [PMID: 31029011 DOI: 10.1016/j.clinimag.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/02/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
The notochord is an essential part of human development that regresses with age. Masses derived from notochordal tissue may be encountered during imaging of the neuroaxis. Fortunately, the majority of these are benign and can usually be differentiated by radiological and clinical findings. In this manuscript, we discuss the clinical and radiologic presentation of the four notochordal derived masses and present a brief overview of their management.
Collapse
Affiliation(s)
- Samia K Sayyid
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Philip K Wong
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - William Read
- Department of Hematology and Oncology, Emory University Hospital, Atlanta, GA, USA
| | - David K Monson
- Department of Orthopaedic Surgery, Emory University Hospital, Atlanta, GA, USA
| | - Monica Umpierrez
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Felix Gonzalez
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Aparna Kakarala
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Adam D Singer
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA.
| |
Collapse
|
23
|
Du J, Xu L, Cui Y, Liu Z, Su Y, Li G. Benign notochordal cell tumour: clinicopathology and molecular profiling of 13 cases. J Clin Pathol 2018; 72:66-74. [DOI: 10.1136/jclinpath-2018-205441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023]
Abstract
AimsTo study the clinicopathological and molecular features of benign notochordal cell tumours (BNCTs) and their differential diagnosis from chordoma.Methods13 cases of BNCT were investigated. The genome-wide copy number imbalances were performed using Oncoscan CNV array in three cases and fluorescence in situ hybridisation (FISH) detection of epidermal growth factor receptor (EGFR)/chromosome 7 enumeration probe (CEP7), LSI1p36/1q21, LSI19p13/19q13, CEP3/CEP12 and Telvysion 6 P was performed in 13 cases.ResultsAll 13 BNCTs were symptomatic and eight cases showed a close relationship with the bones of the skull base. The important histological character for differential diagnosis with chordoma was the absence of extracellular matrix and eosinophil cells and the presence of vacuoles in most tumour cells. Immunohistochemical staining of AE1/AE3, vimentin, epithelial membrane antigen, S-100 and brachyury (100% each) were positive in BNCTs. Gain of chromosome 7 occurred in 10 cases (76.9%), gain of 1p in four (30.8%), gain of 1q in five (38.5%), gain of 19p and 19q in five (38.5%), gain of chromosome 12 in 11 cases (84.6%), gain of 6p in eight (61.5%) and gain of chromosome 3 in four cases (30.8%).ConclusionsIn contrast to chordoma, chromosome gain or normal copy number was more common while chromosome loss was infrequent in BNCTs. This may be a differential diagnosis clue for chordoma and may be an important characteristic in the progression of notochordal cell tumours.
Collapse
|
24
|
Updates in Primary Bone Tumors: Current Challenges and New Opportunities in Cytopathology. Surg Pathol Clin 2018; 11:657-668. [PMID: 30190146 DOI: 10.1016/j.path.2018.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The review summarizes the current diagnostic challenges in fine-needle aspiration of primary bone tumors, with focus on the application of new molecular and immunohistochemical techniques in the diagnosis of giant cell-rich neoplasms, chondrosarcomas, and notochordal tumors.
Collapse
|
25
|
Zhang H, Yang K, Ren T, Huang Y, Tang X, Guo W. miR-16-5p inhibits chordoma cell proliferation, invasion and metastasis by targeting Smad3. Cell Death Dis 2018; 9:680. [PMID: 29880900 PMCID: PMC5992191 DOI: 10.1038/s41419-018-0738-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 12/17/2022]
Abstract
Aberrantly expressed miRNAs play a crucial role in the development of multiple cancer types, including chordoma. However, the detailed molecular mechanisms are unclear and need to be elucidated. In this study, miRNAs were screened by miRNA array analysis and then confirmed by real-time PCR analysis. We found that miR-16-5p was significantly downregulated in chordoma, and overexpression of miR-16-5p suppressed chordoma cell proliferation, invasion and migration in vitro and in vivo and correlated with the upregulated expression of E-cadherin and downregulated expression of N-cadherin and vimentin. Furthermore, Smad3 was identified as a target of miR-16-5p, and Smad3 was highly expressed in chordoma tissues. Further research showed that knockdown of Smad3 had an effect similar to that of overexpression of miR-16-5p in chordoma cells. Our findings demonstrate that miR-16-5p plays a tumor suppressor role in chordoma progression by targeting Smad3, which could provide a promising prognostic and therapeutic strategy for chordoma treatment.
Collapse
Affiliation(s)
- Hongliang Zhang
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
| | - Kang Yang
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
| | - Tingting Ren
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
| | - Yi Huang
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China
| | - Xiaodong Tang
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China. .,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.
| | - Wei Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China. .,Beijing Key Laboratory of Musculoskeletal Tumor, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.
| |
Collapse
|
26
|
Cui JF, Hao DP, Chen HS, Liu JH, Hou F, Xu WJ. Computed tomography and magnetic resonance imaging features of cervical chordoma. Oncol Lett 2018; 16:861-865. [PMID: 29963156 PMCID: PMC6019881 DOI: 10.3892/ol.2018.8721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 09/01/2017] [Indexed: 11/24/2022] Open
Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) scans of 11 patients with histologically proven cervical chordoma were retrospectively evaluated. Imaging features assessed included location, morphology, association with adjacent structures, vertebral destruction, status of cortical bone, periosteal reaction, attenuation and calcification by CT, and signal intensity and enhancement pattern by MRI. Of 7 cases with CT, 6 exhibited lytic-sclerotic bone destruction. A total of 5 cases exhibited pressure erosion of outer cortex, 3 of which had spiculated periosteal reaction. Calcification was observed in 3 cases. All cases were heterogeneous and hypodense. MRI T2-weighted images (n=10) revealed heterogeneous hyperintense (n=5), intermediate (n=2) and intermediate-hyperintense signal intensity (n=3). Hypointense septa between lobules (n=5) and stripes (n=3) were observed on T2-weighted images. Post-contrast magnetic resonance images (n=6) demonstrated marked heterogeneous (n=3) and ring-like (n=3) enhancement. CT scanning is valuable in revealing the lytic-sclerotic bone destruction, pressure erosion of outer cortex and calcification. MRI is useful in demonstrating the results of soft tissue mass. The two examinations are necessary for differential diagnosis of patients with suspected cervical chordoma.
Collapse
Affiliation(s)
- Jiu-Fa Cui
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Da-Peng Hao
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Hai-Song Chen
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Ji-Hua Liu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Feng Hou
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wen-Jian Xu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| |
Collapse
|
27
|
Immunophenotypic features of dedifferentiated skull base chordoma: An insight into the intratumoural heterogeneity. Contemp Oncol (Pozn) 2018; 21:267-273. [PMID: 29416431 PMCID: PMC5798418 DOI: 10.5114/wo.2017.72385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 08/26/2017] [Indexed: 01/05/2023] Open
Abstract
Chordomas are rare and low-grade malignant solid tumours, despite their histologically benign appearance, that arise in the bone from embryonic notochordal vestiges of the axial skeleton, a mesoderm-derived structure that is involved in the process of neurulation and embryonic development. Chordomas occurring in the skull base tend to arise in the basiocciput along the clivus. Three major morphological variants have been described (classical, chondroid, and atypical/dedifferentiated). The pathogenesis and molecular mechanisms involved in chordoma development remain uncertain. From a pathological standpoint, the microenvironment of a chordoma is heterogeneous, showing a dual epithelial-mesenchymal differentiation. These tumours are characterised by slow modality of biologic growth, local recurrence, low incidence of metastasis rates, and cancer stem cell (CSC) phenotype. The main molecular findings are connected with brachyury immunoexpression and activation of the downstream Akt and mTOR signalling pathways. The differentiation between typical and atypical chordomas is relevant because the tumoural microenvironment and prognosis are partially different. This review provides an insight into the recent and relevant concepts and histochemical markers expressed in chordomas, with special emphasis on dedifferentiated chordomas and their prognostic implications.
Collapse
|
28
|
Arain A, Hornicek FJ, Schwab JH, Chebib I, Damron TA. Chordoma arising from benign multifocal notochordal tumors. Skeletal Radiol 2017; 46:1745-1752. [PMID: 28776089 DOI: 10.1007/s00256-017-2727-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/22/2017] [Accepted: 07/10/2017] [Indexed: 02/02/2023]
Abstract
This case reports a 25-year-old woman initially diagnosed with adjacent benign notochordal cell tumors (BNCTs) of L3 and L4 based on needle biopsy of L3 and stable imaging over a 3-year period who was ultimately found to have a chordoma arising from a BNCT at L3. It illustrates the potential relationship between benign and malignant notochordal tumors and the difficulty in distinguishing them by clinical, radiological, and even histopathological means.
Collapse
Affiliation(s)
- Abdulrehman Arain
- Departments of Orthopedic Surgery and Pathology, SUNY Upstate Medical University Syracuse, Upstate Bone and Joint Center, Suite 100, 6620 Fly Road East Syracuse, New York, NY, 13057, USA
| | - Francis John Hornicek
- Departments of Orthopedic Surgery, Pathology, and Radiology Massachusetts General Hospital, Boston, MA, USA
| | - Joseph H Schwab
- Departments of Orthopedic Surgery, Pathology, and Radiology Massachusetts General Hospital, Boston, MA, USA
| | - Ivan Chebib
- Departments of Orthopedic Surgery, Pathology, and Radiology Massachusetts General Hospital, Boston, MA, USA
| | - Timothy A Damron
- Departments of Orthopedic Surgery and Pathology, SUNY Upstate Medical University Syracuse, Upstate Bone and Joint Center, Suite 100, 6620 Fly Road East Syracuse, New York, NY, 13057, USA.
| |
Collapse
|
29
|
Martínez Gamarra C, Bernabéu Taboada D, Pozo Kreilinger JJ, Tapia Viñé M. Benign notochordal cell tumors. RADIOLOGIA 2017; 60:167-170. [PMID: 28778351 DOI: 10.1016/j.rx.2017.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 06/20/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
Benign notochordal cell tumors (TBCN) are lesions with notochordal differentiation which affect the axial skeleton. They are characterized by asymptomatic or non-specific symptomatology and are radiologically unnoticed because of their small size, or because they are mistaken with other benign bone lesions, such as vertebral hemangiomas. When they are large, or symptomatic, can be differential diagnosis with metastases, primary bone tumors and chordomas. We present a case of a TBCN in a 50-year-old woman, with a sacral lesion seen in MRI. A CT-guided biopsy was scheduled to analyze the lesion, finding that the tumor was not clearly recognizable on CT, so the anatomical references of MRI were used to select the appropriate plane. The planning of the approach and the radio-pathological correlation were determinant to reach the definitive diagnosis.
Collapse
Affiliation(s)
| | | | - J J Pozo Kreilinger
- Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, España
| | - M Tapia Viñé
- Servicio de Radiología, Hospital Universitario La Paz, Madrid, España
| |
Collapse
|
30
|
Zhou H, Jiang L, Wei F, Joeris A, Hurtado-Chong A, Kalampoki V, Rometsch E, Yu M, Wu F, Dang L, Liu X, Liu Z. Prognostic Factors in Surgical Patients with Chordomas of the Cervical Spine: A Study of 52 Cases from a Single Institution. Ann Surg Oncol 2017; 24:2355-2362. [DOI: 10.1245/s10434-017-5884-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Indexed: 12/16/2022]
|
31
|
Frequency and Risk Factors for Additional Lesions in the Axial Spine in Subjects With Chordoma: Indications for Screening. Spine (Phila Pa 1976) 2017; 42:E37-E40. [PMID: 27254658 DOI: 10.1097/brs.0000000000001723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE We aim to evaluate the frequency and clinical significance of additional lesions in the axial spine in subjects with chordoma and to assess the need for screening. SUMMARY OF BACKGROUND DATA Chordomas are rare tumors that may be multicentric or metastasize and affect several bones in the axial spine. The incidence of multiple lesions in the axial spine is unknown. Understanding the incidence rate of multiple lesions in the spine in subjects with chordomas will help guide utilization of total spine screening imaging. METHODS We performed a retrospective review of medical records of 42 subjects with histologically confirmed chordomas who had complete imaging of the axial spine. Lesions with imaging characteristics suggestive of chordomas/notochordal remnants were identified. Data on age at diagnosis, sex, size (in maximal dimension), type of chordoma (conventional, chondroid, or dedifferentiated), and whether pulmonary metastases were present were recorded. Binomial two-sample tests of proportions were used to compare proportions. Logistic regression was used to assess predictors of additional lesions. RESULTS Forty-two subjects (57.1% male) were identified. The proportion of subjects with additional lesions in the axial spine was 16.7% (7/42). Age, sex, size, and subtype of chordoma were not significant predictors of having additional lesions (P > 0.05 for each variable). However, having pulmonary metastases was a significant predictor of having additional lesions (P < 0.05). CONCLUSION Approximately 17% of subjects with chordomas had additional lesions in the axial spine. It is unclear whether these represent metastases, synchronous primary chordomas or notochordal remnant tissue. Screening imaging of the axial spine may reveal additional lesions in particular in subjects with pulmonary metastases. LEVEL OF EVIDENCE 3.
Collapse
|
32
|
|
33
|
Abstract
T-box genes are important development regulators in vertebrates with specific patterns of expression and precise roles during embryogenesis. They encode transcription factors that regulate gene transcription, often in the early stages of development. The hallmark of this family of proteins is the presence of a conserved DNA binding motif, the "T-domain." Mutations in T-box genes can cause developmental disorders in humans, mostly due to functional deficiency of the relevant proteins. Recent studies have also highlighted the role of some T-box genes in cancer and in cardiomyopathy, extending their role in human disease. In this review, we focus on ten T-box genes with a special emphasis on their roles in human disease.
Collapse
Affiliation(s)
- T K Ghosh
- School of Life Sciences, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - J D Brook
- School of Life Sciences, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom.
| | - A Wilsdon
- School of Life Sciences, Queens Medical Centre, University of Nottingham, Nottingham, United Kingdom.
| |
Collapse
|
34
|
Cañete AN, Bloem H, Kroon H. Tumores primarios de columna. RADIOLOGIA 2016; 58 Suppl 1:68-80. [DOI: 10.1016/j.rx.2016.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 12/17/2015] [Accepted: 01/05/2016] [Indexed: 11/26/2022]
|
35
|
Sun X, Hornicek F, Schwab JH. Chordoma: an update on the pathophysiology and molecular mechanisms. Curr Rev Musculoskelet Med 2016; 8:344-52. [PMID: 26493697 DOI: 10.1007/s12178-015-9311-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Chordoma is a rare low-grade primary malignant skeletal tumor, which is presumed to derive from notochord remnants. The pathogenesis of chordoma has not been fully elucidated. However, recent advances in the molecular biology studies have identified brachyury underlying the initiation and progression of chordoma cells. More efforts have been made on accumulating evidence of the notochordal origin of chordoma, discovering signaling pathways and identifying crucial targets in chordomagenesis. In this review, we summarize the most recent research findings and focus on the pathophysiology and molecular mechanisms of chordoma.
Collapse
Affiliation(s)
- Xin Sun
- Section of Orthopedic Oncology, Department of Orthopedic Surgery, Harvard Medical School, Massachusetts General Hospital, Yawkey 355 Fruit Street, Boston, MA, 02114, USA
| | - Francis Hornicek
- Section of Orthopedic Oncology, Department of Orthopedic Surgery, Harvard Medical School, Massachusetts General Hospital, Yawkey 355 Fruit Street, Boston, MA, 02114, USA
| | - Joseph H Schwab
- Section of Orthopedic Oncology, Department of Orthopedic Surgery, Harvard Medical School, Massachusetts General Hospital, Yawkey 355 Fruit Street, Boston, MA, 02114, USA.
| |
Collapse
|