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Sacrococcygeal chordoma

Case contributed by Amro Omar
Diagnosis certain

Presentation

Bowel and bladder dysfunction.

Patient Data

Age: 42
Gender: Female
mri

Sagittal and axial STIR show a large, well-defined soft tissue mass engulfing the distal sacrum and coccyx, with extension into the pre-sacral space and dorsal soft tissues. The mass is hyperintense with linear hypointense septa.

Case Discussion

This case illustrates an histologically proven sacrococcygeal chordoma. 

Chordomas are destructive bone tumors with large soft tissue component. Their distribution follow: Sacrococcygeal > spheno-occipital > mobile spine. Usually they are presented with an hyperintense T2WI signal, with multiple septa. They show normal or decreased uptake on bone scan

Differential diagnoses include:

  • giant cell tumor
  • chondrosarcoma
  • metastases
  • plasmacytoma

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