One-year follow-up after partial sacrectomy without stabilization in sacral chordoma: A case report and literature review

INTRODUCTION AND IMPORTANCE: Chordoma is a rare sarcoma of the bone with a slow-growing nature but an aggressive nature locally. The subtle onset and minor symptoms cause a delayed diagnosis. Unfortunately, Chordoma is discovered when the prognosis is poor, which make the management procedure more difficult. CASE PRESENTATION: A 56 years old woman presented with back pain, bowel and bladder dysfunction, and numbness around the anus for the last six months. Sensory examination revealed hypoesthesia on the S2-S4 dermatomes and the rectal toucher revealed a mass. Pelvic x-ray revealed an osteolytic lesion on the sacrum and a MRI revealed a sacrum mass on S2. Confirmed by a CT Scan lumbosacral contrast that revealed a solid mass with osteolytic and osteosclerotic changes on the sacrum bone from S2 to the coccyx. We performed a partial en bloc sacrectomy by posterior approach with an inverted goblet incision without lumbopelvic stabilization. CLINICAL DISCUSSION: A few months after surgery, the patient still had some similar complaints and went to physiotherapy and radiotherapy on a regular basis. 1 year follow-up, there was no recurrence process proven by adjunct examination and the improvement was demonstrated by the relief of back pain, and ability to do daily activities. CONCLUSION: Chordoma can be improved by partial sacrectomy without lumbopelvic stabilization that revealed good results from function and complication. A multi-professional approach to the patient is essential.