Chordoma is a rare neoplasm of bone that develops from the remnants of the primitive notochord. We present a 78-year-old woman with metastatic chordoma to the left ventricle. She had been diagnosed with sacral chordoma 5 years earlier, and chordoma gradually spread to numerous muscles, the ankle joint of the left leg, bilateral lungs, and the brain, despite repeated surgical excisions and carbon heavy-ion radiotherapy. Positron emission tomography/computed tomography showed an abnormal accumulation in the heart, with features similar to the other metastatic lesions. Transthoracic echocardiography could not provide a clear view of the heart, but multidetector computed tomography revealed that a giant abnormal mass was attached to the apical inferior segment of the left ventricle. The patient stated that she did not want to undergo surgical resection for the cardiac mass. The chordoma has been slowly increasing in size, but she has remained asymptomatic without cardiovascular events for more than a year since the diagnosis of cardiac metastasis.
<Learning objective: Multidetector computed tomography provided information not only about the structure morphology of the left ventricular mass, but also about the pathological features using the attenuation values of computed tomography, enabling us to make a diagnosis of a metastatic lesion to the left ventricle from sacral chordoma.>
