Missed tumors of the sacrum

Tumors of the sacrum are frequently missed. The actual diagnosis is often long delayed. The low index of suspicion and the difficulties in obtaining adequate X rays of this region due to the presence of gas bubbles and fecal matter in the bowel which obscure the bony markings of the sacrum are factors which contribute to the problem. Furthermore, myelography of the lowest portion of the dural sac may lead to wrong or confusing information. Six cases from a neurosurgical practice of more than 40 years are presented. Methods to ensure early diagnosis and treatment of tumors of the sacrum are described. Computed tomography available during the past several years has become the most important aid in the evaluation of lesions of the sacrum.