Differential Diagnosis of Clival and Spinal Tumors

Abstract Chordomas and chondrosarcomas are distinct pathological entities that share many clinical–radiological similarities. Furthermore, a variety of different tumors may also be a part of their differential diagnosis. These include other primary osseous tumors, cartilaginous, soft tissue, and central nervous system neoplasms as well as congenital, nonneoplastic, and metastatic secondary lesions. Proper management of cranial base and spinal tumors depends, among other factors, on accurate diagnosis. A multidisciplinary team of physicians with significant experience with complex skull base and spinal pathologies should, ideally, evaluate these patients so as to decrease the likelihood of diagnostic errors and treatment delays. This chapter discusses the clinical, radiological, and histological characteristics of cranial base and spinal tumors by which they can be distinguished from chordomas and chondrosarcomas.