Late recurrence of cervical spine chordoma: illustrative case

The case is notable due to the extreme length of time between the initial resection and the recurrence. The frequency of follow-up imaging is determined by how complete the resection was, but in general, chordomas should be imaged every 6 months for the first 5 years. After 5 years, annual MRI for at least 15 years is recommended by the Chordoma Foundation. However, this case shows that recurrence can occur later than 15 years, suggesting that annual MRI with and without contrast for the duration of life may be more prudent to detect late recurrence. https://thejns.org/doi/10.3171/CASE25337.