Cutaneous Metastasis from Sacral Chordoma

Kristyna Gleghorn, Brandon Goodwin, Ramon Sanchez

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Chordoma is a rare primary bone malignancy of notochord origin, representing 1-4% of malignant bone tumors. 1,2 Typically, chordomas follow a slow progressive course with aggressive local extension, multiple recurrences, and metastases. 1 Of particular interest to this case, cutaneous metastasis is exceedingly rare. Diagnosis of this entity can be a challenge due to the rarity of chordoma, as well as the infrequent presentation of distant cutaneous metastasis and non-specific clinical skin findings. We report a case of a 61-year-old male with a history of sacral chordoma treated by wide local excision 8 years prior to presentation developed a nodule on his scalp for 6 weeks. Physical examination revealed a 1 cm rubbery, pink, shiny dome-shaped nodule on his left occipital scalp. Hematoxylin and eosin sections revealed a lobular dermal proliferation of small ovoid cells and larger physaliferous cells with hyperchromatic, displaced nuclei and finely vacuolated "soap-bubble" cytoplasm in a myxoid stroma. Immunohistochemistry of tumor cells showed positivity for both S-100 protein and pancytokeratin (AE1/AE3), while smooth muscle actin (SMA), P63, and CK7 were negative. Additionally, tumor cells stained positive for brachyury. The medical history, clinical presentation, histopathological appearance and immunohistochemical profile are consistent with cutaneous metastasis from sacral chordoma, known as chordoma cutis. This case illustrates the integral role of dermatopathology in the diagnosis of a rare and critical condition. ©

Original languageEnglish (US)
Pages (from-to)e54-e57
JournalAmerican Journal of Dermatopathology
Volume39
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Chordoma
Neoplasm Metastasis
Skin
His-His-His-His-His-His
Scalp
Neoplasms
Notochord
Bone and Bones
Soaps
S100 Proteins
Hematoxylin
Eosine Yellowish-(YS)
Physical Examination
Smooth Muscle
Actins
Cytoplasm
Immunohistochemistry
Recurrence

Keywords

  • brachyury
  • chordoma
  • chordoma cutis
  • cutaneous metastasis
  • notochord tumor
  • parachordoma
  • sacrococcygeal chordoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

Cite this

Cutaneous Metastasis from Sacral Chordoma. / Gleghorn, Kristyna; Goodwin, Brandon; Sanchez, Ramon.

In: American Journal of Dermatopathology, Vol. 39, No. 4, 01.04.2017, p. e54-e57.

Research output: Contribution to journalArticle

Gleghorn, Kristyna ; Goodwin, Brandon ; Sanchez, Ramon. / Cutaneous Metastasis from Sacral Chordoma. In: American Journal of Dermatopathology. 2017 ; Vol. 39, No. 4. pp. e54-e57.
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