CHORDOMAS

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A brain chordoma is a rare type of tumor that arises from remnants of the notochord, a structure present during early embryonic development. These tumors typically occur along the spine and at the base of the skull, known as the clivus. Chordomas are slow-growing but can be aggressive and invade nearby bone and soft tissue.

Chordomas are very rare, accounting for about 1% of all bone tumors and less than 0.2% of all primary brain tumors. They are most commonly diagnosed in adults between the ages of 40 and 70, with a slight male predominance.

The symptoms of a brain chordoma depend on its size and location. Common symptoms include:

• Headaches
• Visual disturbances, such as double vision or loss of vision
• Difficulty swallowing
• Hearing loss or ringing in the ears
• Facial pain or numbness
• Weakness in the limbs
• Difficulty with balance and coordination
• Changes in speech or voice

Diagnosing a chordoma involves several steps:

• Medical History and Physical Exam: Your doctor will review your symptoms and perform a neurological examination to check for changes in brain function.
• Imaging Tests: MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans provide detailed images of the brain and spine to detect the presence of a tumor.
• Biopsy: A sample of the tumor may be taken and examined under a microscope to confirm the diagnosis and determine the type of cells involved.

Treatment for chordomas often involves a combination of approaches due to their complex nature. Options include:

• Surgery: Surgical removal of the tumor is usually the first line of treatment. The goal is to remove as much of the tumor as possible, although complete removal can be challenging due to the tumor's location near critical structures.
• Radiation Therapy: High-dose radiation therapy, including proton beam therapy or stereotactic radiosurgery, is often used after surgery to target any remaining tumor cells and reduce the risk of recurrence.
• Medications: Although there are no specific drugs approved for chordomas, clinical trials are ongoing to explore potential targeted therapies and other treatments.

There are various surgical techniques for removing chordomas, depending on their size and location:

• Endoscopic Endonasal Surgery: This minimally invasive approach involves accessing the tumor through the nasal passages and sinuses, often used for tumors at the base of the skull.
• Open Craniotomy: For larger or more complex tumors, an open craniotomy may be necessary. This involves making an incision in the skull to access and remove the tumor.
• Spinal Surgery: If the chordoma is located along the spine, spinal surgery may be required to remove the tumor and stabilize the spine.

Early detection and treatment of chordomas can improve outcomes and quality of life. If you experience any symptoms or have concerns about chordomas, it's important to consult your healthcare provider for a thorough evaluation.