Sacral chordoma with unusual posterior radiographic presentation

Chordoma is a malignant neoplasm believed to arise from notochordal remnants. It is most often found in the midline of the sacrococcygeal region (50%), skull base (35%), and the mobile spine (15%). When present in the sacral region, chordomas most often grow anteriorly. We present an unusual case of sacral chordoma with posterior extension.