Presacral parachordoma causing intestinal obstruction in a patient with renal failure: Report of a case

Parachordoma is usually lobulated and pseudoencapsulated, grows slowly, and is only locally invasive. It rarely occurs in the retroperitoneal area. Differential diagnoses include chordoma, extraskeletal myxoid chondrosarcoma, and subcutaneous sacrococcygeal myxopapillary ependymoma. We herein report our experience with a huge presacral parachordoma causing intestinal obstruction. A 48-year-old woman was a hemodialysis-dependent patient with end-stage renal disease. She had been diagnosed with uterine myomas several years prior. The patient presented with signs of intestinal obstruction. A presacral tumor with severe compression on the rectum resulting in rectal stricture was found. A resection of the presacral tumor was difficult owing to its large size and the difficult location of the tumor, tendency for high blood loss, and the patient's poor physiological status secondary to uremia. Resection of the lesion was complicated by intraoperative bleeding and late occurrence of a pelvic abscess, which was successfully treated by computed tomography-guided drainage.