Ressecção sacrococcígea por volumoso cordoma invadindo forame isquiático: relato de caso / Sacrococcygeal resection of a voluminous chordoma invading the sciatic pelvic foramen: case report

RESUMEN

Chordoma is a rare and locally invasive bone malignant tumor derived from embryonic notochordal remnants. Most of them originate from the sacrococcygeal region and present with a large size at the moment of the diagnosis. The treatment consists of extended resection en bloc with sacral nerves, if necessary. Chemotherapy and radiation therapy are of limited utility. The authors present the case of a 74-year-old male patient with a voluminous sacrococcygeal chordoma invading the pelvic sciatic foramen. His symptoms were lower limb pain and partial fecal and urinary incontinence. The tumor was resected by a combined approach (abdominal and posterior), with exiguous margins. The post-operative course was uneventful besides a liquor fistula which resolved spontaneously. The patient had resolution of the pain, but maintained the sphincter dysfunction. At the moment, he is at the 4th month of follow-up.