J Rhinol.  2019 May;26(1):47-51. 10.18787/jr.2019.26.1.47.

Incidentally-Discovered Extraosseous Cystic Nasopharyngeal Chordoma in a Papillary Thyroid Cancer Patient

• Kim H
• Kim JH
• Lee K
• Kim TH

• KMID: 2449029
• DOI: http://doi.org/10.18787/jr.2019.26.1.47

Abstract

Skull base chordomas are rare, malignant tumors arising from primitive notochord remnants of the axial skeleton and comprise approximately 25-35% of all chordoma cases. Nasal endoscopy in previous case reports has characterized nasopharyngeal chordomas as firm, semi-translucent masses protruding from the posterior nasopharyngeal wall with a pink, "meaty" appearance. However, the nasopharyngeal chordoma in the present case had a soft, cystic appearance, unlike the tumors previously described. Herein, an unusual case of an incidentally discovered nasopharyngeal chordoma is reported in a patient with papillary thyroid cancer; the discovered chordoma had a benign cystic appearance with no abnormal positron emission tomography-computed tomography (PET-CT) uptake.

Keyword

Nasopharyngeal mass; Clivus; PET-CT

MeSH Terms

Chordoma*
Cranial Fossa, Posterior
Electrons
Endoscopy
Humans
Notochord
Skeleton
Skull Base
Thyroid Gland*
Thyroid Neoplasms*

Figure

• 

  Fig. 1 Endoscopic discovery of a nasopharyngeal mass (A: right and B: left nasal cavity). The nasopharyngeal mass has a gray-yellowish, cystic appearance.

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  Fig. 2 Axial cut of preoperative enhanced CT scan. White asterisk indicates soft tissue density lesion of nasopharynx.

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  Fig. 3 Preoperative PET-CT scan reveals no unusual hypermetabolism in the nasopharynx. White asterisk indicates the nasopharyngeal lesion.

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  Fig. 4 White arrows indicating residual tumor in midline nasopharynx in post-biopsy MRI (A: T1 imaging showing mixed low and high signal intensity, and B: T2 imaging showing bright high signal intensity).

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  Fig. 5 Sagittal CT scans in chronological order (A: Preoperative, B: post-biopsy, and C: post-wide excision). Anterior and inferior walls of sphenoid sinus are removed after wide excision.

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