We report four new cases of chordoma of “the mobile spine”, all at the L2 level. Diagnosis was often delayed due to predominantly
nonspecific low back symptoms; however, neurological involvement is more frequent than in chordoma with a sacrococcygeal localization.
No pathognomonic images have been described for any imaging modality, and differential diagnosis should include metastases,
chondrosarcoma, and giant-cell tumor. Histopathological analysis can be performed on CT-guided puncture biopsy samples, but
a high level of suspicion must be present and, if there is any doubt, inmunohistochemical studies should be carried out. Despite
being the treatment of choice, complete tumor resection by a double-approach spondylectomy is barely feasible at the L2 level.
Key words Chordoma - Lumbar spine - Surgical treatment
Received: 8 April 1997 Revised: 14 October 1997 Accepted: 24 October 1997