PMC5088663_01
PMC5088663_02
CT images of patient 2 treated with pazopanib. a CT scan at start of pazopanib showing a large sacral chordoma reaching from S2 to coccygis. Measurements: 20 x 16 x 13 cm (AP x LR x CC). b CT scan after 15 months of pazopanib showing progressive disease. Measurements: 21 x 24 x 23 cm (AP x LR x CC)
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PMC5088663_02_13569_2016_59_Fig1_HTML.jpg
Fig1
Initial imaging showed a chordoma of the sacrum with a maximum diameter of 18 cm, compressing the rectum and bladder (see Fig. 1a). After 15 months however, there were clinical and radiological signs of progression (maximum diameter of 24 cm, see Fig. 1b).
PMC5088663_03
PMC5088663_04
PMC5088663_05
MRI images (T2 gadolinium and fat suppression) of patient 5 treated with sunitinib. a MRI scan at start of sunitinib showing a large retroperitoneal metastasis of a primary lumbar spine chordoma. Measurements: 10.3 x 10.7 x 9.4 cm (LR x AP x CC). b MRI scan after 6 months of sunitinib showing a partial response according to RECIST 1.1. Measurements: 9.5 x 7.4 x 8.3 cm (LR x AP x CC). c MRI scan showing progressive disease after 27 months of treatment. Measurements: 8.9 x 10 cm (LR x AP)
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PMC5088663_05_13569_2016_59_Fig2_HTML.jpg
Fig2
The MRI scan before the start of sunitinib treatment showed a large retroperitoneal metastasis with a maximum diameter of 11 cm (anterior posterior [AP] measurement, see Fig. 2a). Follow-up MRI scans after 3 and 6 months showed a partial response according to RECIST 1.1 within the retroperitoneal lesion, shrinking down to maximum AP diameter of 7.5 cm (Fig. 2b). On progression, the patient was switched to imatinib and sirolimus combination treatment, which resulted in further tumour growth after 4 months (Fig. 2c).