Sacral chordoma en-bloc resection and lumbar-iliac stabilization.

Dr. Ruy Yoshiaki okaji – Avenida Monte carmelo 800 17519-030 Marília SP brasil. e-mail: [email protected] Chordoma is a rare malignant bone tumor originated from embryonic remains of notochord. Restricted to the axial skeleton, it is more frequently found in the sacrococcygeal (60%) and cervical spine (30%) areas. It occurs with a frequency twice larger in man than in women and it is uncommon in people with age under 40 years, occurring predominantly between the 5 and 7 decades of life. The diagnosis is performed through the clinical features, physical examination, including rectal touch and image, being the computed tomography (CT) and the magnetic resonance imaging (MRI), the main methods to delimitate the local extension of the tumor. Because of its unfavorable evolution, that is, slow, with unspecific symptoms and locally aggressive, its precocious diagnosis is difficult to be performed. According to the literature, the most frequently reported symptomatology is pain. Most of the sacral chordomas are initially presented with a considerable extra axial tumoral growth. Metastases are not frequent and most of the pathologists consider chordomas as on a low malignant degree. The differential diagnosis involves giant cell tumors, chondrosarcoma, lymphoma and metastatic adenocarcinoma. The surgical treatment is the only healing form, but, due to the possibility of impairment on neural and adjacent structures by the tumor, its total resection results in important functional deficits. We report the case of a female patient with swelling and pain on the sacral area and partial loss of strength of inferior limbs with evolution in one year.