Recurrence of Clival Chordoma along the Surgical Pathway

Summary: Chordomas are locally aggressive malignant tu-mors of notochordal origin whose metastatic potential is increasingly recognized. Surgical pathway recurrence has been noted only rarely in the literature. We present three patients with clival chordomas whose sole or initial recur-rence was along the pathway of prior surgical access. A characteristic mass found along the pathway of prior sur-gical access for resection of a chordoma should suggest re-current chordoma. Chordomas are locally aggressive tumors of no-tochordal origin (1, 2). Sites of origin include the sacrococcygeal region, clivus, and vertebral col-umn. After treatment, which typically includes both surgery and radiation therapy, tumors may recur locally (at the primary site) or may form nodal o