A 21-year-old female is referred with a one-year history of neck pain, difficulty swallowing, and numbness of the tongue. Physical, ophthalmologic, and neurological exams are all unremarkable. An MRI later demonstrates the findings seen here and a chordoma is suspected.
Image credit: @mmm2292.
Answer: Cervical spine
This patient’s presentation and imaging findings are suggestive of a chordoma in the cervical spine. Chordomas are rare, locally aggressive neoplasms that are thought to arise from embryonic remnants of the notochord. They can occur anywhere on the axial skeleton with 50% arising in the sacrococcygeal region. Complete resection is the preferred first-line treatment, although due to anatomic restraints it may not always be possible.
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