Benign Notochordal Tumor: An Embryological Whisper

Abstract We present the case of a 31-year-old woman with a history of thoracolumbar scoliosis surgically corrected. In the context of lower back pain refractory to conservative treatment, imaging studies were performed, including MRI and CT of the lumbosacral spine and sacroiliac joints. An incidental finding revealed a nodule on the posterior aspect of the S1 vertebral body, with imaging characteristics suggestive of a Benign Notochordal Tumor. No other significant alterations were detected. Benign notochordal cell tumors are rare lesions derived from Notochordal remnants, often discovered incidentally during imaging. These tumors are most frequently located in the clivus and sacrum, where they exhibit characteristic imaging findings, including mild sclerosis, preservation of trabecular bone, and the absence of aggressive features such as cortical destruction or soft tissue involvement. While Benign notochordal cell tumors are benign and typically indolent, their differentiation from chordomas, which are malignant and aggressive, is essential to prevent overtreatment and ensure proper management.