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Surgical Treatment of an Endolymphatic Sac Tumor

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Two-Stage Excision of Advanced, Infiltrative Sacral Chordoma.

Nathan Walter¹, Taylor L Wilkinson¹, Nicole Nuñez¹

¹Department of Surgery, University of Tennessee College of Medicine Chattanooga, TN, USA.

The American Surgeon

|August 26, 2025

Summary

This summary is machine-generated.

This study presents a case of sacral chordoma management, emphasizing en bloc resection and adjuvant radiotherapy for optimal outcomes in this rare axial spine malignancy. Achieving negative margins is crucial for preventing recurrence.

Keywords:

colorectal general surgery orthopedic special topics surgical oncology

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Area of Science:

Oncology
Neurosurgery
Radiotherapy

Background:

Chordomas are rare axial spine malignancies originating from primitive notochordal cells.
Optimal management involves en bloc resection with negative margins, potentially augmented by adjuvant radiotherapy.
Pelvic structure involvement complicates surgical management, necessitating multidisciplinary teams.

Purpose of the Study:

To present a case of a large, locally invasive sacral chordoma.
To review current management strategies for sacral chordomas based on recent literature.
To discuss tumor workup, surgical approaches, and prognostic factors.

Main Methods:

Case presentation of a 52-year-old male with sacral chordoma.
Surgical excision using a combined anterior-posterior approach.
Narrative literature review of studies from 2005-2025.

Main Results:

The patient underwent successful resection and adjuvant radiation therapy.
The patient experienced no recurrence at 1-year follow-up.
Literature review covered tumor diagnosis, surgical techniques, and recurrence factors.

Conclusions:

En bloc resection with negative margins and adjuvant radiotherapy are key for managing sacral chordomas.
Multidisciplinary care and high-volume centers improve outcomes.
Further research into prognostic factors and operative technologies is warranted.