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Comparison of various demographic, location, and imaging features of chordomas with those of the most common imaging differential diagnoses
ChordomaGCTChondrosarcomaPlasmacytoma
Age at diagnosis (range) (peak yr)40–6020–3030–7030–60
Most common location in mobile spineCervicalLumbar (sacrum much more common)LumbarThoracic
Commonly involves posterior elements–+++
Intratumoral calcificationAmorphous–Rings and arcs–
T2WI↑↑↓→↑↑
Extraosseous extension+++–
Characteristic featureDumbbell or mushroom shapeLytic lesion without sclerotic rim; fluid-fluid levelsIntratumoral chondroid matrixMinibrain, soap bubble
  • Note:—GCT indicates Giant cell tumor; –, features absent; +, features present; ↓→, hypo- to iso-intense intralesional signal; ↑, hyperintense intralesional signal.