Sacrococcygeal Chordoma

MYS Soo, L Wong

Hong Kong J Radiol 2002;5:117-25

The imaging findings in 5 cases of sacrococcygeal chordoma and 4 patients with other sacral tumours (1 primary neurogenic tumour, 1 metastatic tumour from primary disease in the breast and 1 from the kidney, and an abdominal paraganglioma) are presented to highlight features that may be peculiar to chordomas. Both chordomas and other sacral tumours show heterogeneous high signals on T2-weighted magnetic resonance imaging sequences and similar enhancement characteristics following intravenous contrast. In chordomas the appearance of numerous intralesional septations is distinguishing. On computed tomography, chordomas show characteristic calcification, and the size of the extrasacral soft tissue component can be seen to exceed the intraosseous counterpart. Magnetic resonance imaging is the imaging modality of choice in surgical planning and for long term management.