Spinal chordoma: radiologic features in 14 cases.

The radiologic appearance of chordoma of the cervical (three patients), thoracic (four patients), and lumbar spine (seven patients) was studied. Eleven patients were over 50 years old and presented with long-standing back pain. All were examined with conventional radiographs; three cases also had CT examinations. In thirteen patients, the tumor originated in the vertebral body and, in one patient, in the posterior element of a vertebra. In nine (64%) of the 14 cases, osteosclerosis was a prominent feature. In the remaining five cases (36%), the bone lesion was purely osteolytic. Involvement of the intervertebral disk was found in three patients; in two of these the tumor extended to an adjacent vertebra. In nine patients, a soft-tissue mass was a distinctive additional feature. A sclerotic and/or osteolytic lesion in a vertebral body with a large, paraspinal soft-tissue mass in an older patient with long-standing back pain should raise the possibility of a chordoma.