We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

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A case of malignant granular cell tumour (myoblastoma) which metastasized from the vulva to the regional lymph nodes is presented. Electron microscopy of the metastases demonstrated the presence of numerous intra-cytoplasmic lysosomes, a feature characteristic of these neoplasms, and the neoplasm was shown to stain strongly for carcinoembryonic antigen (CEA) using the immunoperoxidase technique. Previous reports in the literature of malignant granular cell tumours are reviewed and discussed.