Sacrococcygeal chordoma metastatic to the brain with review of the literature

A 29-year-old man presented with headache, confusion, word-finding difficulty, and a visual field deficit 16 months after complete removal of a sacrococcygeal chordoma. Magnetic resonance imaging of the head demonstrated two discrete enhancing left occipital lesions with associated cerebral edema. Both masses were surgically excised and their histological appearance was consistant with chordoma. Chordoma from the sacral region is known to metastasize to the lungs and the vertebral bodies but has rarely been shown to spread to the brain. Dissemination to the brain in this case may be related to the extent of the metastatic pulmonary disease and the anaplastic appearance of the primary tumor.