We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Note |

A Rare Case of Jugular Foramen Chordoma With an Unusual Extension

Raghav C. Dwivedi, MRCS, DOHNS, MS; Bal Krishna Ojha, MS, MCh; Anupam Mishra, MS, DNB; Pouya Youssefi, MRCS; Khin Thway, FRCPath; Mohammed Sultan Ul Hassan, FRCS; Nishant Agrawal, MD; Rehan Kazi, MS, FRCS
Arch Otolaryngol Head Neck Surg. 2011;137(5):513-516. doi:10.1001/archoto.2011.66.
Text Size: A A A
Published online


Chordomas are midline tumors of notochordal origin, occurring anywhere from the skull base to the coccyx. Although one-third of chordomas occur in the spheno-occipital region, to our knowledge only 1 case of jugular foramen chordoma with unusual extension into the neck has been reported in the literature to date. A 21-year-old woman presented with a 3-year history of a large neck mass and partly compensated lower cranial nerve symptoms of insidious onset. Imaging revealed a tumor involving the posterior cranial fossa and carotid space, with widening and erosion of the jugular foramen. Characteristic histopathologic findings and immunohistochemical staining confirmed the diagnosis. The tumor was removed by a combined retrosigmoid and lateral cervical approach. The patient was disease free 18 months after treatment.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Axial computed tomogram showing tumor encroaching in the right carotid space, with erosion of the transverse process and lamina of the axis.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

T1-weighted magnetic resonance images. A, Coronal T1-weighted image showing lobulated tumor with widening of right jugular foramen and posterior fossa extension. B, Sagittal postcontrast fat suppression T1-weighted image showing variegated enhancement with nonenahancing areas of necrosis and anterior displacement of the internal carotid artery.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Microscopic features. A, Histologic features showing a moderately cellular tumor composed of clusters and cords of polygonal cells within a prominent myxoid matrix. The cells show minimally to mildly atypical nuclei and a moderate to abundant amount of cytoplasm that is frequently vacuolated (arrow) (physaliferous cells) (hematoxylin-eosin, original magnification ×200). B, Immunohistochemical staining shows diffuse nuclear expression of S-100 protein within the cords and clusters of cells, supporting the diagnosis of chordoma (original magnification ×40).

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Nonparaganglioma jugular foramen tumors. Otolaryngol Clin North Am 2015;48(2):343-59.