Sacral chordoma, an unusual cause of neurogenic bladder: A case report

Abstract

Introduction and importance: Sacral chordoma is a rare tumor arising from notochord remnants. Scaral pain is the most common sign. We report the case of a sacral chordoma diagnosed in a urology department. It was a rare cause of erectile dysfunction and it was unusually reaveled by lower urinary tract symptoms (LUTS). Case presentation: A 67-year-old man had severe dysuria associated with erectile dysfunction. On digital rectal examination, we palpated a mass protruding through the posterior wall of the rectum. The gluteal region is infiltrated by a firm mass. Magnetic resonance imaging (MRI) revealed an osteolytic sacral tumor. A percutaneous biopsy of the tumor was performed. Pathological examination confirmed the diagnosis of chordoma. Patient had palliative radiotherapy. One year after radiotherapy, he had rectal stenosis associated with severe constipation. Clinical Discussion: Sacral chordoma is a rare malignant tumor. Sacralgia is the most common sign. LUTS and erectile dysfunction were rarely reported in patients affected by this bon tumor. MRI is very suggestive of this pathology. Diagnostic confirmation requires pathological examination. The curative management consists in a large resection of the tumor. For inextricable tumor, palliative radiotherapy can be carried out. The prognosis of chordoma is defined by a high recurrence potential and a low metastatic risk. Conclusions: Sacral chordoma is a rare bon tumor. It is an unusual cause for LUTS and erectile dysfunction. Complete tumor excision is the only curative treatment. Recurrence after treatment is the main challenge for surgeons.