Cordomas del clivus. Consideraciones del tratamiento quirúrgico endoscópico

Abstract

Introduction: Chordomas of clivus are slow growing neoplastic lesions originate by remnant of notochord and invade bone tissue with high rate of recurrence. Objective: To characterize the characteristics of this entity in our Hospital based on it's clinical, radiological, therapeutical and evolutionary aspects. Method: A retrospective descriptive study was performance from the period of January 2010 to December 2015. The sample was 10 patients, 6 men and 4 women, with an average age of 55 years. The surgical approach utilized on all patients was an endoscopic endonasal approach extended to the clivus, supported by intensity modulated radiotherapy (IMRT) hypofractioned or conformed 3D. Results: Headaches and diplopia was the most frequent clinical symptoms. Prevailed classic chordomas with a higher occurrence rate in males with aged 60 and above. Gross total resection was achieved in 80% and 90% of control rate during four year. Complications rates was little and one patient death with CSF fístula and meningitis. Conclusion: Extended endonasal endoscopic approach to the clivus is an excellent and promising surgical option with radical tumour resection and admissible complications.