Cardiac Metastasis from Clivus Chordoma

Background: Chordomas are rare tumors showing locally aggressive nature and high rates of local recurrences. Distant metastases are infrequently reported and cardiac metastases are extremely rare. Case Description: A 32-year-old woman had been diagnosed with a large chordoma involving the clivus. She received a total removal of the tumor and adjuvant intensity-modulated radiotherapy. Four and a half years after the surgery, she presented with multifocal lesions in the ventricles and the right atrium, although an open thoracotomy revealed chronic inflammation. Two years after finding the cardiac lesions, thoracoscopic biopsy of the chest wall lesion revealed metastatic chordoma. She received palliative imatinib for 2 weeks before she died of tumor progression. Conclusion: This case illustrates the metastatic potential of clivus chordoma, and the heart can be a site of metastasis.