OBJECTIVE AND IMPORTANCE: We report an unusual case of ecchordosis phy
saliphora of the thoracic spine. CLINICAL PRESENTATION: The clinical p
resentation was one of disabling thoracic radicular pain without objec
tive neurological deficit. The imaging characteristics of the lesion w
ere those of a cyst containing aqueous fluid. There was no bone destru
ction. INTERVENTION: Cross total removal of the lesion was accomplishe
d. CONCLUSION: We present the only well-documented case of thoracic ex
tradural ecchordosis physaliphora and discuss the relationship between
the notochord, ecchordosis physaliphora, and chordoma. We provide a c
omprehensive list of lesions exhibiting physaliphorous cells.