{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:02:56Z","timestamp":1789171376611,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Chordomas are a low-to-intermediate-grade slow-growing subtype of sarcoma, but show propensity to grow and invade locally with recurrence and metastasis in 10\u201340% of cases. We describe the first case of spontaneous regression of a solid tumor (histologically and immunohistochemically proven chordoma) after COVID-19. A female patient with clival chordoma underwent occipitocervical fixation prior to tumor resection. In the early post-operative stage following the arthrodesis procedure, she was diagnosed with COVID-19. Six months after COVID-19, she finally came back for endoscopic endonasal resection of the tumor and pre-operative MRI surprisingly showed 98.9% regression of the tumor volume. Tumor resection was performed, and both histopathological and immunohistochemistry confirmed diagnosis of chordoma with positive brachyury levels. She showed improvement of right hemiparesis and left-sided tongue palsy. The tumor was comprised of tumor-infiltrating inflammatory cells. CD3 and CD68 were positive, suggesting the presence of T-lymphocytes and macrophages. CD20 and CD56 were negative, suggesting the absence of B-lymphocytes and NK-cells. The authors believe that the onset of COVID-19 exacerbated the patient\u2019s immune response and improved anti-tumor immunity. It was concluded that T-cells, which are involved in the COVID-19 immune response and were found infiltrating the tumor, acted as a critical pathway to this event. Further studies are encouraged in order to gain a better understanding of the SARS-CoV-2\u2013chordoma interaction.<\/jats:p>","DOI":"10.3390\/v17010010","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T19:19:32Z","timestamp":1735154372000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Chordoma Spontaneous Regression After COVID-19"],"prefix":"10.3390","volume":"17","author":[{"given":"Luis Fernando Moura da","family":"Silva Junior","sequence":"first","affiliation":[{"name":"University Hospital of UFMA, Federal University of Maranhao, S\u00e3o Lu\u00eds 65080-805, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyl Eanes Barros","family":"Silva","sequence":"additional","affiliation":[{"name":"University Hospital of UFMA, Federal University of Maranhao, S\u00e3o Lu\u00eds 65080-805, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Adriano Garcia","family":"Campos","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0072-6202","authenticated-orcid":false,"given":"Antonio Augusto Lima","family":"Teixeira J\u00fanior","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Genetics, Faculty of Medicine of Ribeirao Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14049-900, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon Moura","family":"Santos","sequence":"additional","affiliation":[{"name":"Dr. Carlos Macieira Hospital, S\u00e3o Lu\u00eds 65075-441, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando Jos\u00e9 dos","family":"Santos","sequence":"additional","affiliation":[{"name":"University Hospital of UFMA, Federal University of Maranhao, S\u00e3o Lu\u00eds 65080-805, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalino","family":"Salgado Filho","sequence":"additional","affiliation":[{"name":"University Hospital of UFMA, Federal University of Maranhao, S\u00e3o Lu\u00eds 65080-805, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.1007\/s00586-018-5764-0","article-title":"Chordoma: A systematic review of the epidemiology and clinical prognostic factors predicting progression-free and overall survival","volume":"27","author":"Bakker","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s10143-015-0663-x","article-title":"The Molecular Aspects of Chordoma","volume":"39","author":"Gulluoglu","year":"2016","journal-title":"Neurosurg. Rev."},{"key":"ref_3","unstructured":"Tenny, S., and Varacallo, M. (2021). Chordoma. StatPearls, StatPearls Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.2106\/00004623-200508000-00023","article-title":"Disappearance of a Cervical Spine Chordoma after Nonoperative Treatment. A Case Report","volume":"87","author":"Radl","year":"2005","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00701-019-04107-9","article-title":"Spontaneous Regression of a Clival chordoma. Case Report","volume":"162","author":"Bander","year":"2020","journal-title":"Acta Neurochir."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s00701-019-04192-w","article-title":"Letter to the Editor Regarding Spontaneous Regression of a Clival chordoma. Case Report","volume":"162","author":"Passeri","year":"2020","journal-title":"Acta Neurochir."},{"key":"ref_7","first-page":"388","article-title":"Spontaneous Regression of a Clival chordoma: An Unusual Case Report","volume":"83","author":"Vellutini","year":"2021","journal-title":"J. Neurol. Surg. A Cent. Eur. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/bjh.17116","article-title":"SARS-CoV-2-Induced Remission of Hodgkin Lymphoma","volume":"192","author":"Challenor","year":"2021","journal-title":"Br. J. Haematol."},{"key":"ref_9","unstructured":"Pasin, F., Mascalchi Calveri, M., Calabrese, A., Pizzarelli, G., Bongiovanni, I., Andreoli, M., Cattaneo, C., and Rignanese, G. (2020). Oncolytic Effect of SARS-CoV2 in a Patient with NK Lymphoma. Acta Bio Med., 91."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3892\/ol.2024.14302","article-title":"Tumor reduction after SARS-CoV-2 infection in a patient with lung cancer: A case report","volume":"27","author":"Zhang","year":"2024","journal-title":"Oncol. Lett."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17588359211011455","DOI":"10.1177\/17588359211011455","article-title":"Unexpected tumor reduction in metastatic colorectal cancer patients during SARS-CoV-2 infection","volume":"13","author":"Ottaiano","year":"2021","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17588359221138388","DOI":"10.1177\/17588359221138388","article-title":"Genetic landscape of colorectal cancer patients manifesting tumor shrinkage during SARS-CoV-2 infection","volume":"14","author":"Ottaiano","year":"2022","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3403","DOI":"10.3390\/curroncol28050294","article-title":"Spontaneous Regression of Metastatic Renal Cell Carcinoma after SARS-CoV-2 Infection: A Report of Two Cases","volume":"28","author":"Buchler","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1126\/science.abd3072","article-title":"Neuropilin-1 is a host factor for SARS-CoV-2 infection","volume":"370","author":"Daly","year":"2020","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.prp.2009.10.001","article-title":"Cancer Immunoediting and \u201cSpontaneous\u201d Tumor Regression","volume":"206","author":"Sengupta","year":"2010","journal-title":"Pathol. Res. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s40425-018-0458-z","article-title":"Oncolytic Virus Immunotherapy: Future Prospects for Oncology","volume":"6","author":"Raja","year":"2018","journal-title":"J. Immunother. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zaj\u0105c, A.E., Czarnecka, A.M., and Rutkowski, P. (2023). The Role of Macrophages in Sarcoma Tumor Microenvironment and Treatment. Cancers, 15.","DOI":"10.3390\/cancers15215294"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Romero, K., Rodr\u00edguez, R.M., Amedei, A., Barcel\u00f3-Coblijn, G., and Lopez, D.H. (2020). Immune Landscape in Tumor Microenvironment: Implications for Biomarker Development and Immunotherapy. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21155521"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"43","DOI":"10.4103\/0976-9668.82318","article-title":"Immunity over Inability: The Spontaneous Regression of Cancer","volume":"2","author":"Jessy","year":"2011","journal-title":"J. Nat. Sci. Biol. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/CAD.0000000000000337","article-title":"Spontaneous Regression of Tumour and the Role of Microbial Infection\u2013Possibilities for Cancer Treatment","volume":"27","author":"Kucerova","year":"2016","journal-title":"Anticancer Drugs"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"246","DOI":"10.4103\/0019-509X.82887","article-title":"The Role of Innate Immunity in Spontaneous Regression of Cancer","volume":"48","author":"Thomas","year":"2011","journal-title":"Indian J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0065-230X(08)60318-8","article-title":"Peptide-Binding Heat Shock Proteins in the Endoplasmic Reticulum: Role in Immune Response to Cancer and in Antigen Presentation","volume":"62","author":"Srivastava","year":"1993","journal-title":"Adv. Cancer Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1038\/s41577-020-0402-6","article-title":"T Cell Responses in Patients with COVID-19","volume":"20","author":"Chen","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1807836","DOI":"10.1080\/2162402X.2020.1807836","article-title":"Immune Responses during COVID-19 Infection","volume":"9","author":"Melenotte","year":"2020","journal-title":"Oncoimmunology"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Taefehshokr, N., Taefehshokr, S., and Heit, B. (2020). Mechanisms of Dysregulated Humoral and Cellular Immunity by SARS-CoV-2. Pathogens, 9.","DOI":"10.3390\/pathogens9121027"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"107705","DOI":"10.1016\/j.isci.2023.107705","article-title":"SARS-CoV-2 Nsp15 suppresses type I interferon production by inhibiting IRF3 phosphorylation and nuclear translocation","volume":"26","author":"Zhang","year":"2023","journal-title":"iScience"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s13402-019-00454-y","article-title":"The Role of TNF-\u03b1 in Chordoma Progression and Inflammatory Pathways","volume":"42","author":"Gulluoglu","year":"2019","journal-title":"Cell Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/CCO.0000000000000502","article-title":"Chordoma: Update on Disease, Epidemiology, Biology and Medical Therapies","volume":"31","author":"Frezza","year":"2019","journal-title":"Curr. Opin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Pastor, D.M., Lee-Wisdom, K., Arai, A.E., Sirajuddin, A., Rosing, D.R., Korchin, B., Gulley, J.L., and Bilusic, M. (2020). Fast Clearance of the SARS-CoV-2 Virus in a Patient Undergoing Vaccine Immunotherapy for Metastatic Chordoma: A Case Report. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.603248"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:59:53Z","timestamp":1760115593000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,25]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["v17010010"],"URL":"https:\/\/doi.org\/10.3390\/v17010010","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,25]]}}}