DEDIFFERENTIATED CHORDOMA - A CASE-REPORT OF THE CYTOMORPHOLOGIC FINDINGS ON FINE-NEEDLE ASPIRATION

Chordomas are relatively rare neoplasms occurring at both ends of a ne uro axis. The majority follow an indolent course of multiple local rec urrences, ultimately leading to the patient's death. Rare examples hav e been associated with sarcomatous components, usually resembling mali gnant fibrous histiocytoma, fibrosarcoma, or osteosarcoma. These tumor s have followed a more aggressive course, with poor response to treatm ent and death following a relatively short time course. Cytologic mate rial from a single case obtained by fine-needle aspiration revealed a high-grade malignancy composed of short atypical spindle cells contain ing modest amounts of granular cytoplasm. Physaliphorous cells were ab sent, and myxoid material was not a significant component of the smear s. Rare polygonal cells with foamy cytoplasm were identified. Histolog ic study revealed a high-grade spindle-cell sarcoma in which were scat tered small aggregates of vacuolated cells resembling physaliphorous c ells. Anaplastic giant cells were present, and the overall appearance of the neoplasm resembled a malignant fibrous histiocytoma. Despite th e radiographic appearance of a conventional chordoma in this case, the cytologic findings were indicative of a high-grade sarcoma consistent with a dedifferentiated chordoma. (C) 1998 Wiley-Liss, Inc.