Vertebral intra-osseous chordoma or giant notochordal rest?

Chordomas of the lumbar vertebral bodies are rare, We report an unusual cas e of an entirely intraosseous chordoma of the fifth lumbar vertebra treated by vertebrectomy. Conventional radiographs and scintigraphy were normal. T he lesion was well visualised by MR imaging, but showed only slight scleros is on CT. We give our reasons for making a diagnosis of chordoma rather tha n giant notochordal rest and discuss the problems of management resulting f rom this diagnostic dilemma.