Abstract
We report four new cases of chordoma of “the mobile spine”, all at the L2 level. Diagnosis was often delayed due to predominantly nonspecific low back symptoms; however, neurological involvement is more frequent than in chordoma with a sacrococcygeal localization. No pathognomonic images have been described for any imaging modality, and differential diagnosis should include metastases, chondrosarcoma, and giant-cell tumor. Histopathological analysis can be performed on CT-guided puncture biopsy samples, but a high level of suspicion must be present and, if there is any doubt, inmunohistochemical studies should be carried out. Despite being the treatment of choice, complete tumor resection by a double-approach spondylectomy is barely feasible at the L2 level.
Keywords: Key words Chordoma, Lumbar spine, Surgical treatment
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Footnotes
Received: 8 April 1997 Revised: 14 October 1997 Accepted: 24 October 1997