Radical excision of sacrococcygeal tumours

Abstract

Large sacrococcygeal tumours are rare and remain a difficult management problem. Chordomas are one of the most common tumours in this region and may account for 30-40 per cent of postrectal tumours. Four patients aged between 22 and 66 years, three with chordomas and one with a schwannoma, are described. Each was managed by a combined general and neurosurgical approach. Major radical excision of the tumour involving high amputation of the sacrum and lower sacral nerve root division was performed. These large lesions can be radically excised with limited postoperative morbidity and excellent preservation of neurological function, including sphincter control, provided that one S2 nerve root is left intact.

Surgical treatment of sacrococcygeal chordoma

“…Approximately 50% of chordomas occur in the sacrococcygeal region [2,3]. The tumors occur twice as frequently in men as in women and are uncommon under the age of 40 years [4]. The large vacuolated cells (physaliferous cells) are a characteristic of this tumor [5].…”

Cordoma Sacrococcígeo gigante: relato de caso

“…Cordomas são o tipo mais frequente destes tumores (54%) e representam de 1 a 4% de todas as neoplasias ósseas primárias (3,(10)(11)(12) . Cerca de 25 a 35% dos cordomas originam-se na base do crânio, 50 a 60% na região sacrococcígea e 15% nos corpos vertebrais (1)(2)(3)(4)(5)(6)(7)(8) .…”

“…Radiografia simples caracteriza-se usualmente pela visualização imprecisa do sacro (3) . Tomografia computadorizada e, principalmente, ressonância nuclear magnética demonstram tumoração sacral com destruição óssea, comprometimento dos tecidos moles adjacentes, deslocamento anterior do reto e ocasionais calcificações intratumorais (11,15,16) . Macroscopicamente, o cordoma se apresenta como uma massa bem delimitada, de tamanho variável (3 a 20 cm), consistência macia e aspecto mucóide e hemorrágico.…”

Expression of hypoxia-inducible factor-1α, vascular endothelial growth factor and matrix metalloproteinase-2 in sacral chordomas

“…They arise from the sacrococcygeal region in approximately 50% of cases, from the sphenooccipital area in 35% and from the mobile spine in 15% (1). More males than females are affected by sacral chordoma; however, chordomas of the skull base appear to occur with equal frequency in males and females (2). Locally, these tumors are highly aggressive and frequently demonstrate local recurrence even following wide resection (3).…”