[Extensive resection of primary malignant tumors of the sacrum]

The most common primary tumors of the sacrum are chondrosarcoma, and giant cell tumors. These tumors can display a great development at the time of first examination on account of their slow growth, delayed expression of pelvic organs compression and metastases. The spontaneous long lasting evolution of sacral primary tumors is disastrous with neurological involvement, painful visceral complications and a high incidence of lethal evolution. Local control and cure of these tumors is possible only if radical resection is done regardless to neurological sequelae. The author proposes a surgical procedure for a carcinologic resection using two different anterior and posterior approaches in one stage with two teams. Six patients were treated in this way and the follow-up ranges from 5 to 11 years. One patient died two years post-operatively (malignant teratoma); the others survive: 2 chordomas (11 and 5 years post-op.), 2 chondrosarcomas (8 and 6 years pos-op.) and 1 giant cell tumor (6 years post-op.). These results with prolonged survival without recurrence justify our proposal of an aggressive surgical approach to treat these malignant tumors.