Chordoma is a rare cancerous (malignant) primary bone tumor that usually occurs along the spine. Chordoma most often occurs in the base of the spine (sacrum) or in the base of the skull.

Chordomas form from small remnants of the notochord, a coil of cells in the embryo that develops into the spinal cord.

A chordoma may occur at any age but is most common in adults.

Although slow growing, chordomas are difficult tumors to treat because of their close proximity to the spinal cord.

  • Teamwork. At Mayo Clinic, orthopedic surgeons, neurosurgeons, oncologists, radiation oncologists, radiologists, pathologists and rehabilitation specialists work together to care for people with chordoma. Other professionals are included as needed.
  • Experience. Chordoma is a very rare form of cancer. Mayo Clinic doctors have experience diagnosing and treating chordoma.
  • A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people with chordoma includes surgery, radiation therapy, stereotactic radiosurgery, chemotherapy and targeted therapies.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for cancer by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

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Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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Tests and procedures used to diagnose chordoma include:

  • Removing a sample of cells for laboratory testing (biopsy). Biopsy is a procedure to remove a sample of suspicious cells for laboratory testing. In the lab, specially trained doctors called pathologists examine the cells under microscopes to determine whether cancer cells are present.

    At Mayo Clinic, the medical team that performs your biopsy consults with experienced surgeons to plan the procedure so that it can be done in a way that won't interfere with a later operation.

  • Creating images of your spine. Your doctor may recommend imaging tests to help visualize your chordoma and determine whether it has spread beyond the spine. Tests may include MRI or CT.

Treatment for chordoma may include:

  • Surgery. The primary treatment for chordoma is surgery, although it may be difficult to perform because the tumor is near critical structures in the brain and spinal cord. The goal of surgery is to remove the entire tumor in one piece, whenever possible.

    Surgery for chordoma is often complex. At Mayo Clinic, experienced and highly skilled surgeons perform operations to remove chordomas.

  • Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table as a machine moves around you, directing the radiation beams to precise points on your body. Radiation therapy may be used before or after surgery or in cases when surgery isn't an option.
  • Radiosurgery. Stereotactic radiosurgery uses multiple beams of radiation to kill the cancer cells in a very small area. Each beam of radiation isn't particularly powerful, but the point where all the beams meet — at the chordoma — receives a very large dose of radiation to kill the cancer cells.
  • Other treatments. In certain situations, chemotherapy and targeted drug therapy may be used to treat chordoma.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Arizona, a multidisciplinary team of experts, including oncologists, neurosurgeons, orthopedic surgeons and radiation oncologists, works together to care for people with chordoma. Other specialists are included as needed.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Florida, a multidisciplinary team of experts, including oncologists, neurosurgeons, orthopedic surgeons and radiation oncologists, works together to care for people with chordoma. Other specialists are included as needed.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, a multidisciplinary team of experts, including oncologists, neurosurgeons, orthopedic oncologists and radiation oncologists, works together to care for people with chordoma. Other specialists are included as needed.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic doctors and scientists are studying new ways to diagnose and treat chordoma.

Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.

See a list of publications by Mayo Clinic authors on chordoma on PubMed, a service of the National Library of Medicine.

May 01, 2014