Multifocal metastatic chordoma to the soft tissues of the fingertips: a case report including sonographic features and a review of the literature

Chordoma is a rare, locally aggressive tumor which commonly metastasizes, most often to the lung, liver, and spine. In this case report, a 59-year-old male with history of sacral chordoma and pulmonary metastases presented to the emergency department with swelling and discoloration of multiple left...

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Bibliographic Details
Published in:Skeletal radiology 2018-03, Vol.47 (3), p.401-406
Main Authors: Smith, Zachary, Girard, Nicole, Hansford, Barry G.
Format: Article
Language:English
Subjects:
Case Report
Case reports
Discoloration
Emergency medical services
Gout
Imaging
Literature reviews
Liver
Medicine
Medicine & Public Health
Metastases
Metastasis
Nuclear Medicine
Orthopedics
Pathology
Radiographs
Radiography
Radiology
Sacrum
Soft tissues
Spine
Tumors, Embryonal
Ultrasound
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Summary:Chordoma is a rare, locally aggressive tumor which commonly metastasizes, most often to the lung, liver, and spine. In this case report, a 59-year-old male with history of sacral chordoma and pulmonary metastases presented to the emergency department with swelling and discoloration of multiple left fingertips. The initial radiographs led to a presumptive diagnosis of gout, which did not respond to medical therapy. An ultrasound demonstrated multiple solid masses with vascular hyperechoic septations which were subsequently biopsied and proven to be metastatic chordoma. Metastatic disease to the hand is a well documented but rare manifestation of many malignancies. The clinical presentation and radiographic features of multifocal hand metastases may mimic entities such as systemic deposition and granulomatous diseases. To the best of our knowledge, this is the first case report of soft tissue chordoma metastases to the fingertips as well as the first reported sonographic description of chordoma metastases.
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-017-2785-4