Objective: We attempted to define the clinical and imaging features of cervical spine chordoma.
Conclusion: In this series of 10 patients, cervical spine chordomas tended to be large, multilevel destructive lesions of the midcervical region that caused pain and weakness in the neck and shoulder. Typically, these tumors primarily involved the vertebral body and extended into soft tissues of the perivertebral and epidural spaces. Surprisingly, almost a third of the tumors appeared on radiographs to predominantly occupy either the epidural or the intradural space, and nearly half resembled schwannomas. Although no imaging features were pathognomonic, CT and MR imaging were valuable in identifying the tumor, revealing its extent, and defining its relationship to the intraspinal structures.