SACROCOCCYGEAL CHORDOMA-AN INTERESTING SURGICAL CONNUNDRUM CAUSING LARGE BOWEL OBSTRUCTION

Abstract

70 year old gentleman presented with
complaints of low backache for 6
months ,mass abdomen for 3 months
and abdominal distension for 1 month.On
examination,per abdomen-hard immobile
mass palpable in the lower abdomen
,lower limit not palpable.Per rectalhard
extramucosal mass palpable in the
posterior wall of rectum pushing it anteriorly,
upper limit not palpable.Local examination
-hard immobile mass of 6x6 cm
palpable in the sacral region with no fixity
to skin.CECT Abdomen and Pelvis - Expansile
lytic lesion confined to sacrum
involving the surrounding soft tissues,
rectum appears to be displaced anteriorly
suggestive of SACRAL CHORDOMA.
Trucut Biopsy suggestive of
CHORDOMA.Surgery-Pre-sacral dissection,
Abdomino-perineal resection with
end colostomy,Partial Sacral (S3, S4,
S5) and coccyx resection followed by
anatomical closure of the defect.HPE report
was
CHORDOMA (conventional type) with infilteration
into rectum.Post operative
radiotherapy was given and on regular followup.
Keyword :CHORDOMA,SACROCO
CCYGEAL CHORDOMA