Metastatic chordoma with pancreatic disease and response to imatinib

BMJ Case Rep. 2022 Jan 19;15(1):e240062. doi: 10.1136/bcr-2020-240062.

Abstract

A 45-year-old woman presented with a left-sided neck swelling following treatment a year prior for cervical spine chordoma. She had initially been managed surgically with a cervical vertebrectomy and a course of proton beam therapy. Although there had been a degree of residual tissue, her disease remained stable radiologically and clinically. Repeat MRI demonstrated an increasing left paravertebral mass and a head of pancreas metastasis, which shared pathological characteristics with chordoma. Given the advanced metastatic nature of her disease, imatinib was offered with a palliative intent. While waiting for treatment she developed a spinal cord compression, managed with radiotherapy. She commenced imatinib and her disease remained stable for 9 months before progressing clinically and radiologically. This case demonstrates an unusual pattern of metastatic chordoma and provides further rationale for imatinib in such patients.

Keywords: cancer intervention; malignant disease and immunosuppression; oncology; pharmacology and therapeutics; tyrosine kinase inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae
  • Chordoma* / diagnostic imaging
  • Chordoma* / drug therapy
  • Female
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Middle Aged
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / drug therapy
  • Spinal Neoplasms* / diagnostic imaging
  • Spinal Neoplasms* / drug therapy

Substances

  • Imatinib Mesylate