The pathophysiology of chordoma metastasis is not well-documented; however, given their origin from notochordal remnants and their unique histological features, including physaliphorous cells in a myxoid or chondroid matrix, the mechanism might involve the aberrant expression of proteins such as cytokeratin, EMA, S100, and brachyury, which are common in chordomas​​ [10]. This evidence concerns the gene TBX1 and chordoma.