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[A case report of sacral chordoma]
1Department of Surgery, Nagasaki Chuo National Hospital, Japan.
Nihon Geka Gakkai Zasshi
|January 1, 1989
Summary
Sacrococcygeal chordoma, a rare retrorectal tumor, was successfully treated with high sacral resection. This surgical approach, involving collaboration between gastroenterological and orthopedic surgeons, achieved a disease-free outcome.
Area of Science:
- Oncology
- Surgical Oncology
- Radiology
Background:
- Sacrococcygeal chordoma presents diagnostic and surgical challenges due to its rarity and location.
- Retrorectal tumors, including chordomas, require specialized management strategies.
Observation:
- A 64-year-old male presented with chronic anal pain, revealing a presacral mass on digital rectal examination.
- Imaging (radiography, CT, barium enema) demonstrated a retrorectal mass with sacral destruction.
Findings:
- Histological confirmation of sacrococcygeal chordoma via open biopsy.
- Successful en bloc resection of the tumor with S3 vertebrae, preserving bilateral S3 sacral nerve roots.
- Postoperative recovery was uneventful, with no urinary or defecatory disturbances.
- Adjuvant high-dose radiation therapy (80 Gray) was administered, with successful management of a radiation-induced skin ulcer via skin grafting.
Implications:
- High sacral resection via a posterior approach is a viable surgical option for sacrococcygeal chordoma.
- Multidisciplinary surgical collaboration enhances treatment outcomes for complex retrorectal tumors.
- Preservation of sacral nerve roots is crucial for maintaining postoperative function.