Sacrococcygeal giant cell tumour

Case contributed by Dr Fakhry Mahmoud Ebouda

Presentation

An adult male complains of recurrent persistent low back pain and coccydynia long time ago.

Patient Data

Age: 40 years.
Gender: Male
X-ray

Illdefined erosive lesion of the sacrum.

A large destructive mass is seen infiltrating the lower aspect of the sacrum and adjacent part of the coccyx. It has a large presarcal soft tisue component that displaces the rectum. The rectum shows easy flow of luminal contrast materail within it. 

A large destructive midline soft tissue mass is seen infiltrating the lower aspect of the sacrum and adjacent part of the coccyx. It has a large presarcal soft tisue component that displaces the rectum.

Pathology

Electrom microscopy shows giant cells with few stroma. 

Case Discussion

The patient was complaining from low back pain and coccydynia long time ago. Initially he was investigated by plain XR of the lumbosacral spine and coccyx. It suggested erosive lesion of the sacrum. After that the patient underwent pre and post contrast study of the lumboscaral spine and coccyx. It showed a definite sacrococcygeal destructive mass with a large soft tissue component that displaces the rectum.Lastly CT is requested with IV and transrectal contrast to assess the relation of the large associated presacral mass with the pelvic structures specially the rectum. We can also trace the median and two lateral sacral arteries, the main arterail supply of the mass to ensure good haemostasis during surgical intervention. After resection and histopathological examination, it is proved to be giant cell tumor of the sacrum. 

The case is courtesy of Dr/ Nabeeh Bajunaid, Neurosurgeon Consultant, RCMC

Thanks to Dr / Mamdouh Radwan for path. Photo.

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Case information

rID: 26614
Case created: 30th Dec 2013
Last edited: 2nd May 2017
Inclusion in quiz mode: Included

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