A chordoma can develop anywhere along the spine from the base of the skull to the tailbone (coccyx). The most common locations for a chordoma are at the triangular bone near the base of the spine (sacrum), the coccyx, and the clivus, which is a bone in the base of the skull. The clivus is located in front of the brainstem and behind the back of the throat.
Symptoms vary from one person to another and depend in part upon the location and size of the tumor. Chordomas located in the lower spine may be associated with lower Back Pain and tenderness, Pain the legs, Weakness and numbness in the lower back or legs, and abnormalities affecting the bladder and intestines including loss of bladder control (urinary incontinence) and/or loss of bowel control. In some cases, a mass may be felt (palpable) over the small of the back.
Chordomas of the skull base (cranial chordomas) can be associated with double vision (diplopia), headaches, and/or facial pain. Paralysis (palsy) of certain facial nerves can also occur, resulting in swallowing difficulties, speech and voice abnormalities, and abnormal eye movements.
In some cases, an intracranial chordoma can block the flow of cerebrospinal fluid (CSF), causing CSF to accumulate in the skull and putting pressure on the brain (hydrocephalus). Hydrocephalus can cause several symptoms that differ based upon age. In infants, it can cause bulging at the soft spots on the skull, an increase in head circumference, and downward casting of the eyes (sunsetting). In older children, it can cause nausea, vomiting, sleepiness, double vision, rapid eye movements and difficulties with balance. In adults, it can also cause headaches, changes in personality, and difficulty focusing the eyes.
Chordomas in the area immediately below the skull (cervical spine) can cause neck pain, hoarseness, Difficulty swallowing (dysphagia), and, less often, bleeding from the voice box (laryngeal bleeding).