Metastatic chordoma with pancreatic disease and response to imatinib

Klejnow, Eleanor V. and Hoban, Katie and Nixon, Ioanna and Elswood, Thomas Robert (2022) Metastatic chordoma with pancreatic disease and response to imatinib. BMJ Case Reports, 15 (1). e240062. ISSN 1757-790X (

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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.