PMC5914121_01
Histopathologic and immunohistochemical evaluation. (a) Chordoma with expansive invasion (hematoxylin-eosin-HE, 10x). (b) Epithelioid eosinophilic cells in myxoid matrix (HE, 200x); (c) INI-1 positive/preserved expression in neoplastic cells (immunohistochemistry, 200x); (d) Ki-67 positive in neoplastic cells (immunohistochemistry, 200x).
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The mitosis figures were observed up to 04/10 high-power fields (HPFs) (Figures 1(a) and 1(b)). Despite the morphological and immunoexpression of cytokeratins, EMA and vimentin in neoplastic cells, expression of brachyury in the neoplasia was not detected (Figures 1(c) and 1(d)).
Baseline and posttreatment imaging showing multifocal recurrence of spinal chordoma and tumor reduction following treatment with pazopanib. In the left column (a, c, e, and g): baseline lumbar spine MRI. In the right column (b, d, f, and h): follow-up abdominal MRI.
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One month after the end of the radiotherapy treatment, a new MRI was performed (Figures 2(a)-2(g)), which indicated disease progression outside the radiated area. Restaging scans were performed following approximately 3 months of treatment with pazopanib, showing a reduction in size of previously described lesions in anterior paravertebral region, right psoas, and abdominal musculature, and stable dimensions of remaining foci of disease; no new lesions were characterized (Figures 2(b)-2(g)).