cervical spondylosis

Chordoma of the Clivus: Definition and Management

The chordomas are rare tumors that develop from remnants of the notochord. The chordomas of the clivus are histologically benign, but may be locally malignant.

 

They represent 0,1 to 0,2% of intracranial tumors, but constitute 40% of spheno-occipital tumors. In this article, we will discuss the definition and support of the chordoma of the clivus.

Anatomy of the clivus

 

The clivus is a bony structure located at the base of the skull. It consists of two parts: the superior clivus and the inferior clivus. The superior clivus is made up of three bones: the ethmoid, the sphenoid, and the occipital.

 

Clivus Chordoma of the clivus
Source

 

These bones form a triangular shape, with the ethmoid bone at the top and the occipital bone at the bottom.

 

The lower clivus consists of a single bone, the basilar part of the occipital bone. This bone extends downward from the rest of the occipital bone and forms a tablet-like structure.

 

The clivus is connected to the spine by a strong ligament called the tectorial membrane. This ligament runs from the base of the skull to the top of the cervical spine.

 

The clivus plays an important role in holding the head upright and supporting the neck muscles. It also helps protect vital structures, such as the brainstem and cerebellum.

 

 

 

Chordoma clivus what is it? Definition

 

Le chordoma is a type of cancer that develops in the bones at the base of the skull or in the spine. The clivus is a bone located at the base of the skull, and the chordoma clivus is a rare but aggressive form of the disease.

 

Chordoma Chordoma of the clivus
Source

 

The chordomas are slow-growing tumors, but they can invade nearby tissues and organs and cause significant damage.

 

Treatment of chordoma usually involves surgery to remove the tumour, followed by radiation therapy to kill the remaining cancer cells. In some cases, chemotherapy may also be used.

 

 

What are the causes ?

 

Un chordoma is a type of cancerous tumor which develops from the remnants of the notochord, a structure that forms during fetal development and runs along the spine.

 

The majority of chordomas occur in the bones at the base of the skull, specifically in the area where the spine and the skull meet (called the clivus). Although the exact cause of chordoma is unknown, several risk factors have been associated with the disease.

 

These include genetic mutations, exposure to ionizing radiation, and previous treatment for other cancers.

 

The chordomas are relatively rare tumours, with an estimated incidence of only 1 or 2 cases per million people each year. However, they can be difficult to treat due to their location near sensitive brain structures.

 

Therefore, it is important to know the potential causes of the chordoma to improve the early diagnosis and treatment of this disease.

 

 

Symptoms of Chordoma clivus

 

The chordomas grow slowly, but can invade nearby tissues and organs and cause significant damage.

 

Symptoms of chordoma clivus may vary depending on the size and location of the tumour. The most common symptoms are:

 

  • Headaches
  • Pain in the neck
  • Nausea and vomiting
  • Double vision
  • Difficulties swallowing or breathing

 

If you experience any of these symptoms, it is important to see your doctor immediately for diagnosis and treatment.

 

 

 

Diagnosis of Chordoma of the Clivus

 

The diagnosis of chordoma clivus begins with a medical history and physical examination. Your doctor will ask you about your symptoms and any potential risk factors.

 

Un neurological examination will be done to check for signs of nerve damage. Imaging tests, such as an MRI or CT scan, may also be requested to better visualize the tumor.

 

In some cases, a biopsy may be needed to confirm the diagnosis. During a biopsy, a small sample of tissue is taken from the tumor and examined under a microscope.

 

Once the diagnosis is confirmed, your doctor will determine the stage of the disease. The chordomas are classified into three stages.

 

  • Stage I: The tumor is small and has not spread to nearby tissues.
  • Stage II: The tumor is larger or has spread to nearby tissues but not to distant organs.
  • Stage III: The tumor has spread to distant organs

 

The stage of the disease helps guide treatment decisions.

 

 

Treatment of chordoma clivus

 

There is no one-size-fits-all approach to treating chordoma of the clivus. Treatment options vary depending on the size and location of the tumor, as well as your general health.

 

Surgery is usually the first line of treatment for chordomas. The goal of surgery is to remove as much of the tumor as possible while preserving surrounding structures.

 

By itself, surgery is generally not curative for chordomas. Therefore, adjuvant therapies, such as radiation therapy or chemotherapy, may be recommended to kill the remaining cancer cells.

 

In some cases, radiation therapy may be used as the first treatment option. It is usually only considered if the tumor is inoperable or if the patient is not a good candidate for surgery.

 

 

The side effects of treatment can vary depending on the type and extent of treatment received. Common side effects of treatment for chordoma are fatigue, nausea and vomiting.

 

It is important to discuss the risks and benefits of all treatments with your doctor before making any decisions.

 

References

  1. https://www.chordomafoundation.org/learn/comprendre-le-chordome/
  2. https://www.primomedico.com/fr/cure/chordome/
  3. https://www.lombafit.com/chordome/

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