Chordoma: radiologic evaluation of 20 cases

Area of Science:

• Neurosurgery
• Orthopedic Oncology
• Pathology

Background:

• Chordomas are rare, slow-growing bone tumors arising from notochordal remnants.
• They can occur along the spine, skull base, or sacrum, presenting diverse clinical manifestations.

Purpose of the Study:

• To summarize the clinical and radiological features of 20 chordoma cases.
• To highlight common presentations and diagnostic findings of intracranial, vertebral, and sacral chordomas.

Main Methods:

• Retrospective review of 20 patient cases with confirmed chordoma.
• Analysis of clinical presentations, radiological findings (including calcification and bone erosion), and anatomical locations.

Main Results:

• Intracranial chordomas (3/4) often present as sellar tumors, with some preserving the clivus despite extensive lesions.
• Approximately 50% of chordomas show clival erosion at diagnosis; calcification is seen in 50%-70% of intracranial tumors.
• Vertebral chordomas involve multiple vertebrae with destructive, sclerotic lesions and paraspinal masses; sacral chordomas present as midline destructive lesions with presacral masses.

Conclusions:

• Chordoma presentation varies significantly by location, with distinct radiological characteristics aiding diagnosis.
• Early recognition of destructive bone lesions and associated soft tissue masses is crucial for effective management of chordomas.