Findings

On myelography (AP, Lat) the patient was found to have a complete block at T-12 (arrows on AP and Lat); the T-12 vertebral body appeared partially destroyed. A CT scan was performed a few hours later and demonstrated a retroperitoneal mass extending into the spinal canal at the level of the block and destruction of the T12 body. Neoplastic cells of uncertain origin were found at needle biopsy.

A bone scintigram demonstrated a focal "cold" lesion at T-12 (arrow), corresponding to the radiographically evident destructive lesion. There were no other abnormalities.

Radiation therapy was started, but because of progressive worsening of leg weakness and development of incontinence, a decompressive laminectomy was performed from T-11 to L-1. Cord compression, due to tumor within the spinal canal, was evident at surgery. Pathologically, the tumor was felt to represent a chordoma.

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J. Anthony Parker, MD PhD, jap@nucmed.bih.harvard.edu