Skull base chordoma
Chordomas of the skull base are rare and locally invasive and have a poor prognosis.
see also Dedifferentiated skull base chordoma.
Pathogenesis
There is only one skull base chordoma cell line, UM-chor1, freely available to researchers. The established TSK-CHO1 cells were neoplastic, exhibited pleomorphic features, and secreted brachyury, as revealed by immunocytochemical staining or ELISA of conditioned medium (CM). Cells also secreted SOX9, which enhanced brachyury production. The CM of TSK-CHO1 cells promoted the production of hyaluronic acid and type II collagen during the differentiation of human dental pulp stem cells (DPSCs) into fibrocartilage cells. Culture of DPSC pellets in a growth medium supplemented with 10% CM of TSK-CHO1 cells for 2 weeks resulted in the induction of fibrocartilage tissue under normoxic conditions. Brachyury produced by TSK-CHO1 cells promoted the production of collagen type II, peculiar to cartilage, in a dose-dependent manner. The newly established skull base chordoma cell line, TSK-CHO1, is expected to be used for elucidating the pathogenesis of skull base chordoma and for investigating the mechanism underlying the production of fibrocartilage 1).
Clivus chordoma
Treatment
Despite improvements made in the past 10 years in our knowledge of chordoma biology, available therapies still offer a limited benefit. There is an unmet need for new therapeutic options for patients with advanced diseases. Therefore, patients with advanced diseases should be encouraged to participate in clinical trials when and where available 2).
Outcome
Skull base dedifferentiated chordomas are extremely rare and aggressive neoplasms with characteristic magnetic resonance imaging, surgical and histological features. Therefore, an early and accurate histological diagnosis is of paramount relevance. The molecular analysis appears promising to define mechanisms involved in tumor dedifferentiation 3).
Data reveals the clinical prognostic role of albumin and suggest that the fibrinogen/albumin score may be a valuable prognostic grading system in the skull base chordoma 4).