A Rare Presentation of Thoracic Intramedullary Chordoma with Adjacent Bone Involvement: A Case Report and Review of the Literature

Abstract Introduction/Objective Chordoma originates from remnants of the embryonal notochord, and arise in bones anywhere along spine skull base. The most common location was thought to be sacrum, followed by clivus, a much lesser extent rest spine. However, some studies have suggested an equal distribution among base (32%), mobile (32.8%), sacro-coccygeal (29.2%). Here we report case chordoma involving thoracic at level T2. Methods/Case Report A 63-year-old male with no significant past medical history who presented 5-6 months intermittent, bilateral lower extremity weakness numbness trunk extremities. MRI demonstrated contrast enhancing mass T2 vertebral spinal cord compression adjacent bone destruction. T1-3 laminectomy debulking tumor performed. Microscopically, cells lobulated architecture are composed epithelioid arranged cords, clusters or nests, embedded myxoid mucinous matrix. variably vacuolated cytoplasm ("physaliphorous" cells). positive for CK AE1/3, Cam5.2, EMA Brachyury (nuclear stain), S100 (focal). These findings support diagnosis chordoma. Results (if Case Study enter NA) N/A. Conclusion important difficult differential is well-differentiated chondrosarcoma. Although both chordomas chondrosarcomas express S100, do not cytokeratins, brachyury. Chordomas aggressive clinical course poor outcome local extension, recurrence even metastasis. treatment en block surgical resection adjuvant radiotherapy. initial prognostic factor.