Chordoma

Introduction

Chordomas are unusual tumors with seemingly unconventional traits. Most notably, they are malignant primary bone tumors but not sarcomas. They derive from embryologic cell remnants but predominantly affect late-middle-age adults, and they behave aggressively but grow slowly. Chordomas present with long-standing symptoms related to local mass effect or invasion. At the skull base, they often cause headaches and cranial neuropathies. In the spine, they incite low-grade pain and either weakness, numbness, constipation, or incontinence. Imaging interpreters play an important role in initial diagnosis, treatment response, and surveillance for recurrence.