Nasopharyngeal chordoma in a patient with a severe form of sleep-disordered breathing: A case report

Radzikowska,Joanna; Gronkiewicz,Zuzanna; Kukwa,Andrzej; Lisik,Wojciech; Czarnecka,Anna M.; Krzeski,Antoni; Kukwa,Wojciech

doi:10.3892/ol.2015.3393

Nasopharyngeal chordoma in a patient with a severe form of sleep-disordered breathing: A case report

Authors:
- Joanna Radzikowska
- Zuzanna Gronkiewicz
- Andrzej Kukwa
- Wojciech Lisik
- Anna M. Czarnecka
- Antoni Krzeski
- Wojciech Kukwa
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Affiliations: Department of Otorhinolaryngology, Medical University of Warsaw, Warsaw 00‑739, Poland, Department of Otolaryngology and Head and Neck Disease, University of Varmia and Mazuria School of Medicine, Olsztyn 10-082, Poland, Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw 02-005, Poland, Department of Oncology, Military Institute of Medicine, Warsaw 04-141, Poland
Published online on: June 19, 2015 https://doi.org/10.3892/ol.2015.3393
Pages: 1805-1809

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Abstract

Nasopharyngeal chordoma is a rare type of malignant neoplasm that originates in the remnants of the notochord, a primitive tissue of embryonic origin preserved outside the axial skeleton. Approximately one‑third of chordomas are located in the base of the skull, in the midline of the body. The slow growth rate of the tumor, which gradually fills the nasopharyngeal cavity, contributes to a delayed oncological diagnosis. Among its isolated and non‑specific symptoms, the obstruction of the nasopharynx is dominant, thus, sleep‑disordered breathing (SDB) may occur. The current study presents the case of a 32‑year‑old female patient who was incidentally diagnosed with a nasopharyngeal chordoma during a diagnostic examination for SDB. The diagnostic examination was performed as a part of a research program for pathologically obese patients who qualified for bariatric surgery. Following tumor resection, a significant improvement in various polysomnographic parameters occurred, including a decrease in the apnea hypopnea index from 53.5 to 6.4 and an increase in the mean saturation rate from 92.5 to 95%, confirming that an association exists between tumor obstruction of the nasopharynx and SDB. The incidental diagnosis of this rare type of neoplasm drew attention to diagnostic and therapeutic problems associated with nasopharyngeal chordomas. Furthermore, it indicated the necessity for the accurate laryngological examination of patients with SDB.

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