Mehmud Aurangzeb, Farsheed Sartaj.
A case of Sacro-Coccygeal Chordoma mimicking a Pilonidal Sinus.
J Postgrad Med Inst Jan ;16(1):113-5.

A 65 years old man was referred from Jalalabad, Afghanistan with a discharging sinus in the natal cleft region and increasing sacral pain. The referral chit mentioned that the patient had undergone an incision and drainage of the lesion, for what appeared to be a pilonidal abscess, 3 months back. No pus was expressed at the time and since the procedure, sinuses had developed at the site. On examination, a scar and three sinus tracts were observed in the natal cleft region over an underlying mass. On exploration under general anesthesia, a grey, yellowish white firm mass, roughly 15x 10 cms was found extending down to the sacral fascia, ischiorectal fossae, and around into the retro-rectal space. After a tedious dissection, the lesion was excised in toto and a primary suture was preformed. Subsequent histopathology revealed the diagnosis of chordoma. The patient made an uneventful recovery, and at one year follow up, there was no evidence of recurrence.

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