Management issues in chordoma: A case series

This study presents a combined case series of chordomas from two Canadian i nstitutes. Twenty-seven patients were identified for the period 1954-1998. Management issues with regard to diagnostic pitfalls, selection of charged particle treatment and retreatment of recurrences are discussed, The diagno sis of early stage chordoma requires a high index of suspicion. One patient in the series presented with hoarseness and is described in detail. The di agnosis was made coincidentally by a computed tomographic scan of the head, performed after a motor vehicle accident. The planning of both surgery and radiotherapy was optimized by using magnetic resonance imaging. A review o f the literature supports the use of a combined surgical and radiotherapeut ic approach.