Ajlan ATASOY, Sener CİHAN, Birsen Songul CİHAN, Tugba Fahriye KOS, Nalan BABACAN AKGUL

A metastatic parachordoma case

Parakordoma, lokal rekurrens sıklığı fazla olan bir yumuşak doku tümörüdür. İndolen seyir izlemelerine rağmen nadir de olsa metastatik özellik gösterebilirler. Bu makalede beş yıl önce sağ omuzunda kitle nedeni ile opere edilen ve parakordoma tanısı olan 28 yaşında erkek hasta sunulmaktadır. Hastada ilk ameliyatından sonraki iki yıl içinde iki kez lokal nüks gelişmişti. Son olarak hasta metastatik sol retroorbital kitle ile başvurdu. Retroorbital kitleye parsiyel eksizyon yapıldı ve patolojik inceleme ilk tanısı ile uyumlu olarak myoepitelyal tümör metastazı şeklinde rapor edildi. Sistemik değerlendirmede multipl akciğer metastazı ve sağ sakroiliak eklemde metastaz tespit edildi. Sakroiliak ve retroorbital kitlelelere palyatif radyoterapi tamamlandıktan sonra kemoterapi başlandı. Kemoterapi rejimi ifosfamid, mesna ve doxorubisinden oluşmaktaydı. Kemoterapi sonrası değerlendirmelerde akciğer nodüllerinde ve retroorbital kitlede hafif regresyon görüldü. PET/BTde sakroiliak metastazda 18-FDG tutulumu yoktu. Sonuç olarak, parakordomalar metastatik potansiyelleri nedeni ile yakın takip edilmelidir. Sistemik kemoterapide doksorubisin ve ifosfamid başarı ile kullanılabilir.

Bir metastatik parakordoma olgusu

Parachordoma is a soft tissue tumor with a high risk of local recurrence. Despite the fact that parachordomas mostly have an indolent course, distant metastasis can be seen on rare occasion. We hereby report a case of a 28-year-old male who was initially diagnosed with parachordoma five years ago when he presented with a mass on his right shoulder. He suffered from local recurrence twice within the first two years after his surgery. Metastatic disease later presented itself with a mass in his left retro-orbital fossa. The patient underwent a partial surgical resection and the pathologic evaluation was reported asmyoepithelial tumor metastasis . The patient s systemic work up showed bilateral pulmonary metastatic nodules and metastasis in the right sacroiliac joint. After radiotherapy for the sacroiliac and left orbital mass, chemotherapy was initiated. The regimen consisted of ifosfamide, mesna and doxorubicin. Follow-up evaluation revealed a minimal decrease in size in the pulmonary nodules and the retro-orbital mass. There was no 18-FDG uptake in the sacroiliac mass on PET-BT. In conclusion, surveillance carries importance due to the risk of metastasis for patients with parachordoma. Systemic chemotherapy consisting of doxorubicin and ifosfamide could be used successfully.

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