Chordoma - A Clinicopathologic Review of 4 Cases -

척삭종 - 4례의 임상 및 병리학적 검색 -

Chordoma is a slow-growing malignant neoplasm arising from the remnants of the primitive notochord. It accounts for 1 to 4% of all malignant bone tumors. It occurs exclusively along the spinal axis. Authors experienced four cases of chordoma occurred in the sacrococcygeal region. There were two male and two female patients, with a mean age of 63.5 years(range, 57~75 years). Tissue was obtained by wide excision in two patients, by incisional biopsy in one patient and by needle biopsy in the other. Adjuvant radiation therapy was performed on all the patients after their biopsy. The mean diameter of the tumors was 7.6cm(range, 5.5 to 13.0cm). Grossly, tumor was multiobulated, soft and myxoid gelatinous mass. Microscopically, the tumor showed lobulated feature divided by fibrous septa within it. There were physaliphorous cells with vacuolated bubbly cytoplasm. And small uniform, round, and non-vacuolated tumor cells were also present. On immunohistochemical stain, all the cases were immunoreactive for cytokeratin, epithelial membrane antigen(EMA) and vimentin, respectively. One of the 4 cases was positive for S-100 protein. All the cases were negative for CEA.

1988년부터 1999년까지 영남대학교 의과대학 부속병원에서 척삭종으로 진단받은 4례를 대상으로 임상병리학적 특징을 분석하여 다음과 같은 결과를 얻었다. 환자의 연령은 57세에서 75세였고 평균연령은 63.5세였다. 4례 모두 천미골부에서 발생하였다. 종양의 평균 크기는 9.3cm 였다. 종양은 비교적 경계가 비교적 잘 지워지는 섬유성 격벽에 의해 나뉘어지는 분엽성, 점액성, 젤라틴 모습이었고, 조직학적으로 풍부한 점액성 기질과 거품모양의 공포를 갖는 담공포성 세포가 특정적으로 관찰되었다. 4례(100%)에서 종양세포들은 cytokeratin, EMA와 vimentin에 양성반응을 나타내었고, 1례(25.0%)는 S-100 protein에 양성 반응을 나타내었고, CEA에 대하여 모두 음성 반응이었다.