Sacral chordoma

Case contributed by Jini P Abraham
Diagnosis certain

Presentation

Known case of neurofibromatosis. Presented with low backache since few months.

Patient Data

Age: 60 years
Gender: Male
mri

Large heterogenously enhancing lesion noted in the sacral region causing erosion and infiltration of the sacrum and posterior paraspinal muscles. 

Case Discussion

This is a pathologically proven case of sacral chordoma. However, in view of the history, imaging-wise, malignant peripheral nerve sheath tumor could not be ruled out.

Sacral chordoma is the most common primary malignant sacral neoplasm. The tumor arises from intraosseous notochordal remnants. 

Intraosseous peripheral nerve sheath tumors (PNSTs) are rare. Most of the intraosseous PNST arise from head and neck due to the presence of intraosseous nerves in neuroforamina of head and neck.

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