Chordoma, Sacrum

62-year-old female with gradual onset neurogenic bladder symptoms. There is a T1 hypo- and hyperintense mass centered destroying the sacrum. The coronal STIR weighted images demonstrate a predominantly hyperintense lesion with wispy hypointense components. The postcontrast sagittal and coronal fat-saturated T1-weighted images demonstrate heterogeneous enhancement with destruction of the mid to inferior sacrum as well as the coccyx with a markedly distended urinary bladder. A chordoma was favored preoperatively, and the postoperative diagnosis was unchanged. Chordomas represent less than 5 percent of all primary bone tumors. They originate from embryonic remnants of the primitive notochord which can be found from the level of Rathkes pouch to the coccyx. Typical age of presentation is between 30 and 70 years with sacrococcygeal chordomas typically seen in a slightly older age group. Surgical resection, if feasible, history additionally considered the first-line of therapy.