How is a chordoma diagnosed?

Sometimes, especially at the base of the spine, a lump will be found. In other cases, lesions show up on computed tomography (CT) and magnetic resonance imaging (MRI) scans.

A biopsy will be done to diagnose a chordoma and to differentiate it from other types of tumors. The tissue is examined under a microscope, the chordoma can have one of three subtypes: conventional (or classic), chondroid, and dedifferentiated (also called sarcomatous).

Conventional chordomas are most common. They grow slowly but are malignant. Chondroid chordoma grows even more slowly than a conventional chordoma. They are mostly found at the base of the skull. Dedifferentiated chordomas grow quickly.

Because radiological testing can be confusing, chordomas are identified by two types of markers: cytokeratins and brachyury. The brachyury protein is also found in masses that have developed from the notochord, which is the support structure in embryos.

CT and MRI scans are also used to develop strategies for treatment.

Last reviewed by a Cleveland Clinic medical professional on 09/05/2018.

References

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  • Tsuji T, Chiba K, Matsumoto M, et al. Differentiation of spinal giant cell tumors from chordomas by using a scoring system. European Journal Of Orthopaedic Surgery & Traumatology [serial online]. October 2016;26(7):779-784.
  • Young V, Curtis K, Temple H, Eismont F, DeLaney T, Hornicek F. Characteristics and Patterns of Metastatic Disease from Chordoma. Sarcoma [serial online]. December 30, 2015;:1-7.
  • Sawke G K, Sawke NG. Sacrococcygeal chondroid chordoma: A case report with brief literature review. Clin Cancer Investig J 2014;3:116-8
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  • Chordoma Foundation. Understanding Chordoma. Accessed 9/14/2018.
  • Bone Cancer Research Trust. Chordoma. Accessed 9/14/2018.

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