Cytokeratin immunophenotyping of an unusual cervical vertebral chordoma with extensive chondroid foci and perilaryngeal recurrence: A case report with review of the literature

Chordomas are midline, slowly growing, and locally destructive tumors deriv ed from vestigial remnants of the notochord. We present an unusual case of a cervical vertebral chordoma with extensive chondroid change that aggressi vely recurred in the anterior larynx and surrounding neck structures, and s ubsequently in the mediastinum, resulting in the death of the patient. Rece nt literature has investigated and debated the significance of chondroid el ements in chordomas as a differential diagnostic and a prognostic indicator . In particular, the use of immunohistochemical stains for cytokeratin and mesenchymal markers in these areas as a means of distinguishing true from p seudocartilage has received much attention. In this study, we used a spectr um of cytokeratin subtypes (CK 7, 20, 5/6, AE1/3) to further characterize t hese chondroid areas, and observed that they were positive for the majority of the cytokeratin subtypes, suggesting pseudo, rather than true, cartilag inous change. Clinicopathologic features of this lesion and the recent lite rature are reviewed. Copyright (C) 2001 by W.B. Saunders Company.