title: Spine extra-osseous chordoma mimicking neurogenic tumors: report of three cases and review of the literatures.
abstract: BACKGROUND
  For a long time, chordoma has been known as an osseous tumor mainly found at the clivus and sacrococcygeal region. However, spine extra-osseous chordoma (SEC) with a better prognosis than the classic type has been neglected. According to our literature review, only several case reports have been published in English literatures. Here in this article, three cases of SEC, plus a literature review, are presented.
  
  
  METHODS
  Three cases of SEC were presented from our center. Surprisingly, neurologic tumors were considered as the first diagnosis. Thereafter, en bloc resection was performed in all the three cases. Especially, the dumbbell-shaped one in the cervical spine was removed by en bloc through the combined anterior and posterior approach for the first time. Follow-up within 12-58 months after surgeries proved no recurrence or metastasis.
  
  
  CONCLUSIONS
  Spine extra-osseous chordoma, commonly located in the cervical and epidural region, is extremely rarely met. SEC is characterized with less aggressiveness, the lower rate of recurrence and metastasis, and better prognosis than those of the osseous origin. Though complete excision can be achieved generally, differential diagnosis of spine neurogenic tumors and the following en bloc resection should be made as carefully as possible.
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Jian
authors: J
authors: Yang
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Xinghai
authors: X
authors: Yang
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Wujun
authors: W
authors: Miao
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Qi
authors: Q
authors: Jia
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Wei
authors: W
authors: Wan
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Tong
authors: T
authors: Meng
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Zhipeng
authors: Z
authors: Wu
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: Xiaopan
authors: X
authors: Cai
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China. songdw@sh163.net.
authors: Dianwen
authors: D
authors: Song
authors: Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China. jianruxiao83@163.com.
authors: Jianru
authors: J
authors: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002574:Cervical Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D002817:Chordoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D000072226:Computed Tomography Angiography; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D012447:Sacrum / Q000000981:diagnostic imaging; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014711:Vertebral Artery / Q000000981:diagnostic imaging
chemical_list: D005682:Gadolinium
keywords: Differential diagnosis; Neurogenic tumor; Prognosis; Spine extra-osseous chordoma