Metastatic sacral chordoma

Abstract

Sacral chordomas (SC) are rare primary malignant bone tumors of the vertebral column, with an incidence between 0.000005-0.000027%. The aim of this study is to describe a case of metastatic SC. A 42-year-old man, without comorbid conditions arrived at the referral center, presenting with a sacral lesion. MRI showed a tumor measuring 9.3 cm that was suggestive of myeloma or chordoma. A biopsy with histopathology study was performed, confirming the diagnosis of SC. The patient underwent surgical tumor excision. Six months after surgery, the tumor recurred with metastatic vertebral column implants, soft tissues of the chest wall, liver and pleural space, and the patient became paraplegic. There was no indication of adjuvant radiotherapy and/or chemotherapy. There was also no possibility that imatinib would be approved by the Unified Health System. At about 28 months of monthly clinical follow-up, the patient died. The case presented showed unsuccessful SC surgery, which is associated with a worse prognosis. The patient had systemic tumor dissemination and paraplegia a few months after surgery, dying at 28 months of follow-up.