Chordoma radicular metastasis following cerebrospinal fluid dissemination

Chordoma metastases are usually found at advanced stages of the disease. The metastases occur generally in lung, bones, liver and lymph nodes. We report a rare case of radicular chordoma metastasis. A 59-year-old man, operated for a clival chordoma six years ago, was admitted for atypical S1 radiculopathy. The MRI showed lumbar intradural tumor compressing the cauda equina. Surgery was performed. After opening of the dura mater, the tumor was seen tightly attached to the nerve roots and was totally removed. The histological examination confirmed a metastasis of the known chordoma without local recurrence. Chordomas are slowly growing, aggressive malignancies. Mostly complete microsurgical resection reduces local and distant recurrences. Intradural metastases are rare and follow cerebrospinal fluid dissemination from tumor cells. These metastases must be actively cured to achieve longer survival and better quality of life.