Spinal chordoma

Occur primarily in the sacrococcygeal region.

Unlike cranial chordomas, sacrococcygeal chordomas show a male predominance, and these patients tend to be older. May also arise in C2.

see Sacral chordoma.

A rare case of L3 chordoma progressed to an intradural extramedullary (IDEM) mass and distant metastasis to the fascia lata. A 64-year-old female patient presented to a local university hospital due to back pain and received an excisional biopsy for an L3 destructive bony lesion. Local radiation therapy was initially administered, assuming a malignancy of unknown origin, but she developed cerebrospinal fluid leakage during adjuvantradiation therapy, which was managed by wound revision and lumbar drainage. As the destructive lesion progressed, she visited the hospital for a second opinion 3 months after the biopsy. After a review of outside pathology, they diagnosed the lesion to be a chordoma and performed an L3 corpectomy with cage and plate fixation. One and a half years later, positron emission tomography and computed tomography (PET-CT) revealed a right tensor fascia lata hypermetabolic lesion. Excisional biopsy confirmed distant metastasis of the chordoma. One year later, she complained of L2 radiating pain. PET-CT and CT myelogram revealed an IDEM lesion. Surgical excision confirmed the transdural invasion of the chordoma. To our knowledge, this is the first report of an iatrogenic IDEM invasion and distant metastasis to the tensor of the fascia lata by an L3 chordoma ¹⁾.