Sacrococcygeal chordoma presenting as a retro rectal tumour

Abstract

INTRODUCTIONChordomas are rare, slow growing, locally destructive bone tumours arising from the notochord.PRESENTATION OF CASEPresenting a case of a 65 year old man, who presented with complaints of swelling on the right lower back for 1 year associated with pain.On, physical examination, a swelling measuring 5 cm × 4 cm was noted in the lower back with posterior wall indentation on per rectal examination.MRI revealed a mass lesion involving the sacrum (s3–s4) and coccyx. FNAC showed features of a chroma.At surgery, we excised a mass from the retrorectal space and biopsy proved it to be a chondroid chordoma, a variant of chordoma.DISCUSSIONChordomas are solid malignant tumours that arise from vestiges of the foetal notochord. Common locations are the clivus and the sacrococcygeus region.Annual incidence of these tumours is 1 in one million. MRI is the imaging modality of choice. Prognosis improves based on the age, resected margins and postoperative treatment.CONCLUSIONHere, we shall discuss the literature, variants, treatment and prognosis of this rare tumour.

Sacral chordoma with incidental rectal adenocarcinoma: a case report

“…However, the possibility of metastasis cannot be ruled out, and local recurrence usually has a devastating outcome. The five-year survival rate is 51%, and the 10-year survival rate is 35% [ 2 ].…”

“…The incidence rate for chordomas is 0.1/100,000 per year. In addition, they involve the sacrococcygeal region in 50–60% of cases and account for over 40% of all sacral tumors [ 2 ]. It is quite rare to find a primary bone cancer in association with colorectal cancer [ 3 ].…”

“…It is quite rare to find a primary bone cancer in association with colorectal cancer [ 3 ]. Magnetic resonance imaging (MRI) is considered the best modality for diagnosing sacral chordoma [ 2 ]. Total surgical excision with negative margins is the main effective method as curative treatment [ 2 – 4 ].…”

Challenges in Diagnosing Chordoma (Skull Base Tumors)

“…Chordomas are uncommon, locally aggressive malignant bone tumors that develop from the primordial notochord remnants, accounting for 1-4% of all primary malignant bone tumors [1]. Despite the fact that they can form anywhere along the axial skeleton, sacrococcygeal and spheno-occipital locations are most prevalent, followed by cervicothoracic and coccyx [2]. There are also reports of axial destinations and soft tissue involvement.…”