The osseous and angiographic features of vertebral chordomas

Abstract

Eight cases of vertebral chordoma, exclusive of the sacrococcygeus, are presented. The conventional radiographic signs in descending order of importance in differential diagnosis are: destruction of multiple adjacent vertebral bodies; a paravertebral or precervical soft tissue mass; osteosclerosis, seen mainly at the periphery of the destructive lesion; and involvement of the intervening intervertebral disc space. All eight patients had a demonstrable intraspinal extension of chordoma on myelography. Four patients had complete blocks, two epidural in configuration, and two intradural in appearance - indicative of dural invasion by the neoplasm. Four patients had angiographic evaluation. Two demonstrated angiographic features usually associated with soft tissue malignant tumors. Angiography in all four cases was helpful in determining the full extent of the lesion, more so than either conventional radiography or myelography.

Chordoma of the low cervical spine presenting with Horner's syndrome

“…To our knowledge, this is the first case report to describe such growing pattern, whereas the possibility of the encasement of vertebral artery is well known [12,14,16]. To our knowledge, this is the first case report to describe such growing pattern, whereas the possibility of the encasement of vertebral artery is well known [12,14,16].…”

Transarticular invasion of joints by bone tumors: hypothesis

“…Note the huge, intrapelvic, soft-tissue mass the intervertebral disc space. In three series of vertebral chordomas [8,17,23] totalling 35 cases, nine intervertebral disc spaces were invaded (26%). The spaces were narrowed, and the opposing articular margins were partially or completely destroyed.…”

<I>High Cervical Chordoma</I>

“…Conspicuous symptoms, such as weakness and swallowing distur bance, usually occur less than 1 year before diagno sis, but patients often have a longer history of neck pain. 1,2"13) A review of 20 cases of cervical chordoma with symptomatological descriptions', 2,6,7,[9][10][11][12]15) re vealed that five presented with neck pain without conspicuous disabling symptoms at diagnosis, and only three had tumor localized within one vertebral level without epidural or intradural extension. The present case suggests that early detection is possi ble by careful examination of serial roentgeno grams, followed by CT and MR imaging to identify the extent and morphological character of the tu mor.…”