Externalization of a soft tissue chordoma. Case report
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Published on: May 26, 2023
Ernesto Sierra-Montenegro1, Gastón Sierra-Luzuriaga, César Carrilo-Védova
1Servicio de Coloproctología, Hospital del Instituto Ecuatoriano de Seguridad Social, Guayaquil, Ecuador. gesierra21@yahoo.com
Background:
Chordomas are rare, slow-growing tumors that originate in the primitive notochord. The most frequent location is the sacrococcygeal region. It is more frequent in males. Average age is 61 years old. The aim of this study is to report a case of externalization of a chordoma in the sacral region.
Clinical Case:
We present the case of a 62-year-old female whose disease began 4 years before admission, reporting discomfort in the sacral region. In the intergluteal area, the presence of a mass that increased in size during the previous year was noticed and palpated. On proctological examination, a tumor of 6 cm in diameter is found located in the midsacral region 3 cm from the anal canal. On palpation, the tumor is hard and painless with a regular and mobile surface. X-ray of the coccyx was normal. Surgery was performed with total excision and primary closure. Histopathological report was chordoma.
Discussion:
Theoretically, notochord in the vertebral bodies is not completely degenerative and the remaining tissue persists, producing chordomas. The most common symptom is local pain. Diagnosis is made by imaging: x-ray of lumbosacral spine, computed tomography and magnetic resonance imaging. The treatment of choice is wide surgical resection.
Conclusions:
Diagnosis of chordoma is rare but should be kept in mind in patients with pain in lower back or coccyx and, even more so, if accompanied by a mass with years of evolution.