Presentation
Back swelling, loss of bowel control.
Patient Data
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 on T2, STIR and hypointense on T1.
Case Discussion
CT is needed to evaluate and analyze the extent of bone involvement and to recognize the appearances of calcification within the lesion. MRI contributes impressive anatomical delineation of adjoining structures and can characterize the signal of the lesion usually enabling a convincing preoperative diagnosis. MRI is however restricted in its proficiency to assess calcification. Other differential of this appearance would includes chondrosarcoma, lymphoma and metastasis.
The patient is lost to follow up, so histopathological diagnosis is not available.