Thoracic chordoma.

Dra. Rita Delgado – Rua Borges Lagoa 1080 / 307 04038-002 São Paulo SP Brasil. E-mail: [email protected] Chordomas are slow-growing tumors with aggressive local behavior that probably originate from embryonic remnants of the notochord. This is a midline structure along the neural tube that presents involution and fragmentation as ossification of the axial skeleton occurs, in such way that in the second month of intrauterine life, it is restricted to the intervertebral discs, where the nucleus pulposus will appear. Other remnants of the notochord originating outside the discs and within the bones can be found in any topography long the vertebral column but they are preferably found in the sacrococcygeal region (50 to 60%) or in the sphenobasilar region (25 to 40% of the cases). In the remaining portion of the vertebral column (15%) the main localization is the cervix, especially the high cervical spine, followed by the lumbar spine. Chordomas of the thoracic spine are rare and usually present as extradural bone tumors that lead to complaints of pain by instability and intercostal radiculalgia or neurological changes in the lower limbs due to spinal cord compression. We report the case of a thoracic chordoma that presented as a pathological fracture and received a clinical and initial radiological diagnosis of vertebral metastasis.