Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report
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Issued Date
2023-12-01
Resource Type
eISSN
17521947
Scopus ID
2-s2.0-85160881899
Pubmed ID
37268958
Journal Title
Journal of Medical Case Reports
Volume
17
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Medical Case Reports Vol.17 No.1 (2023)
Suggested Citation
Korwutthikulrangsri E., Ongard S., Pisutbenya J., Ruangchainikom M., Sutipornpalangkul W. Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report. Journal of Medical Case Reports Vol.17 No.1 (2023). doi:10.1186/s13256-023-03958-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/83023
Title
Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report
Author's Affiliation
Other Contributor(s)
Abstract
Introduction: Chordomas are rare, locally aggressive tumors that often occur in the axial spine, especially in the sacrum. The treatment of chordomas located in the upper cervical spine is challenging. En bloc resection is the preferred surgical option for total tumor removal. Case presentation: We report the case of a C2 chordoma in a 47-year-old Thai woman. She was treated with a two-stage, anterior–posterior, C2 total spondylectomy with titanium mesh cage reconstruction and radiotherapy. The first stage involved posterior stabilization from the occiput to C5, a total laminectomy, and removal of the posterior rings of the bilateral foramen transversarium to preserve the bilateral vertebral arteries. The second stage comprised a transoral mandibular split with en bloc resection of C2, followed by titanium mesh cage reconstruction and kick-off anterior cervical plating. At the 5 year follow-up, no tumor recurrence was identified on magnetic resonance imaging. The patient had no neurological deficits but still had minor complications from the anterior transoral mandibular split. Conclusions: Excellent midterm results were obtained using a transoral mandibular split with reconstruction and posterior spinal fusion from the occiput to the lower cervical spine coupled with adjuvant radiotherapy. We recommend this approach as the treatment of choice for chordoma in the upper cervical spine.