Clinics in Diagnostic imaging. Sacrococccygeal chordoma

A 41-year-old man with a sacrococcygeal chordoma is presented with emphasis on its morphological and imaging features. Examples of chordomas at other sites situated along the skull base and spinal axis are illustrated. Bone erosion and expanding soft tissue mass are invariably present on both enhanced computed tomography and magnetic resonance imaging. Sacrococcygeal chordomas are usually large on initial presentation and treatment is targeted at complete surgical excision since incomplete resection invariably leads to recurrence and distant metastases. Skull base chordomas are smaller but are less accessible to complete removal. Adjuvant radiotherapy is offered under these circumstances with the view to delay recurrence. The biological behaviour and prognostic factors for survival are summarised.