A 38-year-old man was admitted to our hospital for deep sacral pain. There was no significant medical history. Physical examination revealed pressure pain of the right sacroiliac joint. MRI showed a midline mass in the sacrum (arrows), isointense on T1- weighted MR images and hyperintense on T2-weighted MR images (Fig. A-B), enhancing with gadolinium. Cortical destruction was present with an extraosseous soft tissue mass (arrowheads). A well-defined lesion with similar MRI signal was seen in the left groin (asterisk) (Fig. C). Diagnosis of sacral chordoma with distant metastasis was made.