Ahmed Khan Chaudhry, Muhammad Azam, Faheem Anwar.
Sacrococcygeal Chordoma.
Pak Armed Forces Med J Jan ;52(1):103-4.

A 55 years old male presented with two years history of pain and slowly increasing swelling in the sacral region. The pain was severe in intensity, restricted the movement of the patient and radiated down to both the legs. Six months before the admission he also developed urinary and faecal incontinence. On examination right buttock was prominent with visible swelling over the sacrum extending into the right buttock. It was hard in consistency with irregular surface. Ankle and knee jerks were present and there was sensory loss over S3 and S4 dermatomes. FNAC of the swelling was done which showed large cells with hyperchromatic nuclei and abundant cytoplasm. X-ray of the lumbosacral spine revealed gross destruction of the sacrum and coccyx with associated soft tissue mass, resulting in ground glass appearance. Both sacroiliac joints were intact. MRI showed large heterogeneous mass involving the sacrum and extending posteriorly as well as anteriorly into the pelvic cavity with displacement of the pelvic organs. Spinal cord thecal sac compression with exiting nerve root compression was present. Exploration of the mass was carried out through posterior midline incision. Histopathology showed sections of bone infiltrated by a tumor having lobular architecture. The lobules were separated by fibrous septa and contained cells arranged haphazardly, in cords, sheets and trabeculae. The cells had vacuolated cytoplasm. Some of the cells had eosinophils nonvacuolated cytoplasm. There were large lakes of mucin present in between the cells.

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