Sacral chordoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Pelvic pain and mass feeling.

Patient Data

Age: 75 years
Gender: Female
mri

An 85×45×80mm well-defined lobulated midline sacral mass is noted that destructs sacral vertebrae, obstructs spinal canal, and bulges into presacral and retro sacral spaces. 
The mass is low signal on T1WI and high signal onT2WI.
There is no sign of local invasion to intrapelvic organs such as the rectum and no regional lymphadenopathy. Sacroiliac joints seem to be intact bilaterally.
Diffuse but mild urinary bladder wall thickening is present. 
Post-operative changes are seen at the lower lumbar spine.

Case Discussion

Pathology proved sacral chordoma which is an uncommon malignant tumor of the axial skeleton.
Sacrococcygeal regions are the most common site of chordoma and includes about 30-50% of cases.

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