【Case】 A 71-year-old female patient was admitted to our hospital’s Critical Care and Emergency Department due to septic shock associated with pneumonia. Although the shock was ameliorated by antibiotic treatment, pyothorax was found on computed tomography, which was performed because her fever and severe inflammatory reaction persisted. At the same time, an abscess was found in the thoracic paravertebral region of the posterior mediastinum, and thoracoscopic drainage was performed. Pathological examination revealed a chordoma in the paravertebral region. Because the tumor was spread over four vertebrae, complete resection was not an option, and heavy particle radiotherapy was started instead.
The patient requires continued, careful follow-up.

【Discussion】

Chordomas are a rare, malignant bone tumor arising from the remnants of the embryonic chorda and most commonly involve the sacrococcygeal bone and base of the skull. Vertebral body involvement is rare, and cases of paravertebral chordoma development do not involve direct invasion of the nervous system and are often subclinical and found by chance.

【Conclusion】

Chordoma should be considered in the differential diagnosis of posterior mediastinal lesions arising from the paravertebral body.