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Chordoma is a rare, malignant, primary bone tu-mor (1–4), which arises from remnant cells of the developmental notochord.1 We report an extremely rare case of a metastatic sacral chordoma in the wrist. A 59-year-old man presented in 2012 with a grad-ually enlarging 3 cm bulbous, transilluminating, firm mass over the left volar radial wrist. The mass was suspicious for a ganglion cyst and was aspirated at an outside institution with indeterminate pathology (Fig. 1). The patient had a history significant for a 14 × 12 cm sacral chordoma, which was surgically ex-cised in 2011, with a total sacrectomy and pelvic re-construction and had been disease free for 1 year. An excisional biopsy was performed (Fig. 2), and pathologic analysis revealed a 3 × 3 cm metastatic myxoid chordoma positive for brachyury. Magneti