Chordoma in Orthopedic Surgery Clinical Presentation

Updated: Mar 11, 2019
  • Author: Nagarjun Rao, MD, FRCPath; Chief Editor: Jeffrey A Goldstein, MD  more...
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Presentation

History and Physical Examination

Chordomas present clinically as destructive bony masses with soft-tissue involvement. They erode and impinge upon adjacent structures, giving rise to a wide variety of clinical symptoms.

In the cranial region, these lesions can cause cranial nerve palsies, hydrocephalus, and torticollis (reported in an infant). [13]  The sacral lesions can remain asymptomatic for a long time and/or present with a variety of nonspecific symptoms. These symptoms may involve back pain, changes in bowel habits, or a feeling of fullness in the rectal area. Physical examination must include a rectal examination to exclude a presacral mass. [14]

In children, the tumor may be more aggressive, with a variable histologic picture.