TITLE:
Chordomas and Their Consideration in the Radiographic Differential of Extra-Axial Lesions of the Central Nervous
AUTHORS:
Shih-Shan Lang, Jayesh P. Thawani, Anousheh Sayah, Sriram Venneti, Danielle Brewington, Eric L. Zager, Stephen J. Dante
KEYWORDS:
Chordoma; Primitive Notochord Tumor; Extra-Axial Tumor; Spine
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.2 No.3,
July
19,
2012
ABSTRACT: Due to the rare occurrence of chordomas extra-axially, these lesions have not earned a great deal of consideration in the clinical and radiographic differential diagnoses of extra-axial paraspinal lesions. We describe a case of a patient with a surgically resected extra-axial chordoma and review the radiologic characteristics of chordomas as an entity in the spectrum of extra-axial lesions. A 47-year-old man presented to our institution with four months of intermittent parethesias, pain, and subjective weakness in the left leg. MR imaging of the lumbar spine demonstrated a large heterogeneously- enhancing paraspinal lesion extending from the left L3-4 neural foramen into the psoas muscle. The patient underwent a CT-guided needle biopsy demonstrating features consistent with a chordoma. He then underwent a left retroperitoneal approach and en bloc resection of the lesion from the vertebral column. Pathology confirmed chordoma as the diagnosis. EACs are a rare but important consideration in the diagnosis of extra-axial lesions of the central nervous system.