ArticleJournal of surgical case reports2026
Extra-axial chordoma of the distal tibia incidentally discovered during fixation of a presumed pathologic fracture.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Chordomas are rare malignant tumors of notochordal origin that typically arise along the axial skeleton. Extra-axial chordomas involving the appendicular skeleton are exceedingly uncommon and may present diagnostic challenges due to nonspecific clinical and radiographic features. We report a case of a 59-year-old woman who sustained a low-energy distal tibial fracture and proximal fibula fracture and was found intraoperatively to have an extra-axial chordoma of the distal tibia initially presumed to be a benign cystic lesion. The tumor was excised at the time of fracture fixation, and pathologic analysis confirmed the diagnosis of extra-axial chordoma. This case highlights a highly unusual traumatic presentation of a distal appendicular chordoma and emphasizes the importance of maintaining suspicion for occult pathology in atypical cortical lesions encountered during orthopedic trauma surgery.
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