Escobar-de la Garma VH, Padilla-Vázquez F, Elizalde-Martínez E

Language: Spanish
References: 13
Page: 99-103
PDF size: 139.84 Kb.

ABSTRACT

Chordomas are rare slow growing, locally agressive bone tumours occuring in axial skeleton, with a predominance in the sacrococcygeal region. The mortality of these tumours depends of the rate of recurrence, directly involved with the efficacy of the primary modality of treatment, which in all cases must be surgical with wide resection margins. Objectives: report the case of a sacrococcygeal chordoma and literature review. Clinical case: we present the case of a seventh-decade female with history of en bloc-sacral resection for removal of a sacrococcygeal chordoma 24 years ago. Three months earlier she presented with progressive weakness of right leg and foot, preventing her from walking, plus anaesthesia in right dermatomes L4-S1 and urinary/fecal incontinence. Magnetic Resonance Imaging revealed a well-delimeted giant round pelvic mass 7 cms-diameter, next to the ventral sacral side, destroying adyacent bone with multiple intensities in T2. Biopsy revealed recurrence of sacrococcygeal chordoma despite the long time the patient remained cured. Conclusions: wide-margin surgery is the primary treatment modality in sacrococcygeal chordomas. It is not infrequent to find relapses after en-bloc resection of sacrococcygeal chordomas, and all recurrences must be agressively treated and performed by a multidisciplinary team constituted by neurosurgeons, orthopaedic surgeons, surgical oncologists, plastic reconstructive surgeons and all the people with expertise treating this rare neoplasm.

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