Chordoma Spontaneous Regression After COVID-19

• Published in: Viruses 2024-12, Vol.17 (1), p.10
• Main Authors: Silva Junior, Luis Fernando Moura da, Silva, Gyl Eanes Barros, Campos, Marcos Adriano Garcia, Teixeira Júnior, Antonio Augusto Lima, Santos, Ramon Moura, Santos, Orlando José Dos, Salgado Filho, Natalino
• Format: Article
• Language: English
• Subjects: Arthrodesis; Case Report; CD20 antigen; CD3 antigen; CD56 antigen; Chordoma - pathology; Chordoma - surgery; Consciousness; coronavirus infection; COVID-19; COVID-19 - pathology; COVID-19 - virology; Endoscopy; Female; Headaches; Humans; Immune response; Immunohistochemistry; Infections; Lymphocytes B; Lymphocytes T; Lymphoma; Macrophages; Magnetic Resonance Imaging; Metastases; Middle Aged; Natural killer cells; Neoplasm Regression, Spontaneous; notochord; Pain; Paresis; Patients; Remission (Medicine); Sarcoma; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Skull; Skull Base Neoplasms - pathology; Solid tumors; Spinal cord; spontaneous neoplastic regression; Tumors
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v17010010

Chordomas are a low-to-intermediate-grade slow-growing subtype of sarcoma, but show propensity to grow and invade locally with recurrence and metastasis in 10-40% of cases. We describe the first case of spontaneous regression of a solid tumor (histologically and immunohistochemically proven chordoma) after COVID-19. A female patient with clival chordoma underwent occipitocervical fixation prior to tumor resection. In the early post-operative stage following the arthrodesis procedure, she was diagnosed with COVID-19. Six months after COVID-19, she finally came back for endoscopic endonasal resection of the tumor and pre-operative MRI surprisingly showed 98.9% regression of the tumor volume. Tumor resection was performed, and both histopathological and immunohistochemistry confirmed diagnosis of chordoma with positive brachyury levels. She showed improvement of right hemiparesis and left-sided tongue palsy. The tumor was comprised of tumor-infiltrating inflammatory cells. CD3 and CD68 were positive, suggesting the presence of T-lymphocytes and macrophages. CD20 and CD56 were negative, suggesting the absence of B-lymphocytes and NK-cells. The authors believe that the onset of COVID-19 exacerbated the patient's immune response and improved anti-tumor immunity. It was concluded that T-cells, which are involved in the COVID-19 immune response and were found infiltrating the tumor, acted as a critical pathway to this event. Further studies are encouraged in order to gain a better understanding of the SARS-CoV-2-chordoma interaction.