A very wide range of lesions can occur in and around the sacrum.
Tumors
- primary sacral tumors
- malignant
- sacral chordoma: most common primary sacral tumor 1
- chondrosarcoma
- Ewing sarcoma / pPNET
- osteosarcoma: often arises from Paget disease in this location
- multiple myeloma/plasmacytoma
- benign
- giant cell tumor of bone: 2nd most common primary sacral tumor 1
- aneurysmal bone cyst
- osteoid osteoma
- osteoblastoma: accounts for ~17% of spinal osteoblastoma(s) 2
- cavernous hemangioma of sacrum
- malignant
- neural tumors arising in sacral canal
- pre-sacral tumors
- germ cell tumors
- metastases to the sacrum
Developmental lesions
- spinal dysraphism
- sacral meningocele
- sacral myelomeningocele
- sacral lipomyelomeningocele
Other lesions
- Paget disease affecting the sacrum
- Extramedullary hematopoiesis