Posterior Approach for Total Resection of a Sacral- Coccigeal Chordoma: A Case Report

Isabella Ponzio, Del Bello L, Monia Martiniani, Leonard Meco, Roberto Procaccini, Nicola Giampaolini and Nicola Specchia

Orthopaedic Division, Republic of San Marino, Italy
Department of Orthopaedics, University of Ancona, Italy

^*Correspondance to: Monia Martiniani 

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Abstract:

A young patient refers progressive worst of lower back pain that became localized in the sacral area getting worst while sitting or standing. On clinical examination, a small area over the coccyx gave painful sensations on pressure, VAS scale was 7. Images from RMN showed a well defined coccygeal mass that demonstrated a low signal on T2, bright signal on T1and a disomogeneal structure with enhancement. Destruction of the coccyx without invasion of the gluteal musculature and rectum were present and confirmed by Ct scan. The incisional biopsia was performed to make a certain diagnosis of chordoma. Patient was undergone to radical excision from a posterior approach. The lesion was excised en bloc with the coccyx and fourth to fifth sacral vertebra with at least 2 cm healthy surgical margins. Combined use of post-operative high let radiation to increase diseasefree interval was used. Follow–up was performed by MRI at 40 and 70 days after surgery showing no chordoma recurrence. Effective management of coccygeal chordoma requires early diagnosis, accurate preoperative staging, definitive and adequate surgical resection with proved tumor-free cut margins and closed follow-up.

Keywords:

Chordoma; Coccigeal; Sacral; Posterior; Resection

Cite the Article:

Ponzio I, Del Bello L, Martiniani M, Meco L, Procaccini R, Giampaolini N, et al. Posterior Approach for Total Resection of a Sacral-Coccigeal Chordoma: A Case Report. Clin Oncol. 2018; 3: 1395.