Bone, Chordoma [LMP23535]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Chordoma
Species: 
Human
Organ System: 
Bones, Joints, and Soft-Tissue Tumours
Gender: 
Female
Age: 
61 years
Diagnosis Code: 
ICD-10: C41.2 | ICD-O: 9370/3
Slide Contributor Information
Gao, A., Keith, J.

Keywords

notochord, physaliferous

Clinical History

61-year-old woman with chronic back pain. Neuroimaging shows pathological fracture of the L4 vertebral body.

Clinical Discussion

Chordomas are malignant bone tumours of adults found almost exclusively in the midline, most commonly in the sacrum and skull base. They are thought to arise from embryonic remnants of the notochord. Microscopically, conventional chordomas show a lobular architecture with epithelioid cells growing in nests and cords in a basophilic myxoid stroma. Cytoplasmic vacuoles impart a bubbly, “physaliferous” appearance to the tumour cells. Chondroid and dedifferentiated variants also exist. Chordomas express cytokeratins, S100, and brachyury (see Related Content). Prognosis is affected by tumour location, size, and resectability; sacral tumours generally have the longest overall survival.

Related Content

Brachyury immunohistochemistry