Rare case of an extraosseous cervical chordoma with both intradural and extensive extraspinal involvement

Background Chordomas must be considered among the differential diagnoses for extradural spinal tumors, especially involving the clival or sacrococcygeal regions. They are often locally invasive and destructive to the osseous structures from which they arise, but rarely extend intradurally. Here, we report a unique chordoma that was intradural and spanned nearly four subaxial cervical vertebral levels. Case Description We report the case of an atypical intradural chordoma that spanned four subaxial levels of the cervical spine in an 81-year-old female. It also extended through multiple neural foramina but did not invade or destroy the bony elements of the cervical vertebrae. Notably, it demonstrated sizable extension into the deep carotid triangle abutting the internal jugular vein. Conclusion This case involved an extraosseous, intradural, four-level subaxial cervical chordoma that demonstrated significant extraspinal extension into the anterior soft tissues of the neck.