sacrum chordoma

Sacral Chordoma Description

A sacral chordoma is a rare type of cancer that forms in the sacrum, which is the bone at the base of the spine that forms part of the pelvis [8]. This type of tumor can occur anywhere along the sacrum, but it's most often found near the tailbone [8].

Characteristics

Sacral chordomas are slow-growing tumors that can involve nerves controlling bowel and/or bladder function [6]. They can cause changes in bowel and/or bladder function, pain, aching, tingling, numbness, or weakness of the arms and legs [4].

Prevalence

About 50% of chordomas occur in the sacrum, making it one of the most common locations for this type of tumor [9]. This highlights the importance of being aware of the symptoms associated with sacral chordomas.

Symptoms

The symptoms of sacral chordoma depend on the location and size of the tumor. They can include changes in bowel and/or bladder function, pain, aching, tingling, numbness, or weakness of the arms and legs [4].

It's essential to note that sacral chordomas are rare and slow-growing tumors. However, early detection and treatment can significantly improve patient outcomes.

References:

[4] - Chordomas of the mobile spine and sacrum can cause changes in bowel and/or bladder function, pain, aching, tingling, numbness, or weakness of the arms and legs. [6] - Sacral chordomas, those in the lower spine, may involve nerves that control the bowel and/or bladder function. Most patients are able to manage control using a ... [8] - Chordoma is a slow growing cancer of tissue found inside the spine. Chordoma can happen anywhere along the spine. It is most often found near the tailbone. [9] - Oct 25, 2017 — About 50% of chordomas occur in the sacrum, the bone at the base of the spine that forms part of the pelvis.

Common Signs and Symptoms of Sacral Chordoma

Sacral chordoma, a rare type of cancer that affects the sacrum (tailbone), can cause various symptoms depending on the tumor's size and location. Here are some common signs and symptoms associated with sacral chordoma:

• Persistent Back Pain: A persistent ache or pain in the coccyx or sacrum area is one of the most common symptoms of sacral chordoma [6].
• Numbness or Weakness: Sacral chordoma can cause numbness or weakness in the arms and legs, which may be due to nerve compression or damage [6].
• Pain Down the Legs: Pain that radiates down the legs is another symptom associated with sacral chordoma [8].

It's essential to note that these symptoms can vary depending on the individual case. If you're experiencing any of these symptoms, it's crucial to consult a medical professional for proper diagnosis and treatment.

References:

[6] Sacral chordoma generally causes persistent back ache or pain in the coccyx or sacrum (tailbone). They may cause numbness or weakness of the arms and legs ...

[8] Chordoma near the tailbone can cause pain down your legs ...

To diagnose sacrum chordoma, several diagnostic tests can be employed.

Imaging Tests * Magnetic Resonance Imaging (MRI) scans are commonly used to help doctors make a diagnosis and plan for treatment [6][7]. An MRI is one of the tools used to diagnose a chordoma, which uses magnetic fields and radio-frequency waves to create an image that can show the presence of the tumor [7]. * Computed Tomography (CT) scans may also be used to determine if the tumor has spread [8]. * X-rays are not typically used for diagnosis as chordomas don't show up on x-rays, but other imaging tests like MRI and CT scans can help identify the tumor [9].

Biopsy A biopsy is a procedure where a small sample of cells is taken from the suspected tumor site. This is usually done through a needle biopsy, which involves taking a small sample of tissue for laboratory testing [1]. A biopsy is considered definitive in diagnosing chordoma.

These diagnostic tests can help healthcare providers determine the presence and extent of sacrum chordoma, allowing them to develop an effective treatment plan.

Treatment Options for Sacral Chordoma

Sacral chordoma, a rare and aggressive type of cancer, can be challenging to treat. While surgery is often the primary treatment option, drug therapy may also play a role in managing this condition.

• Imatinib: In some cases, imatinib, a targeted therapy medication, has been used to treat sacral chordoma. A case report [5] described a patient who received palliative radiotherapy and imatinib treatment upon recurrence after partial sacrectomy.
• Erlotinib: Another targeted therapy medication, erlotinib, has also been explored as a potential treatment option for sacral chordoma. However, its efficacy in this context is still being studied [1].
• Targeted therapies and immunotherapy: Researchers are currently investigating experimental therapies, such as targeted therapy and immunotherapy, for the treatment of chordomas, including sacral chordoma [7].

Chemoresistance

It's worth noting that chordoma is a chemoresistant disease, meaning that chemotherapy may not be effective in treating this condition. In advanced cases, imatinib has been shown to have some role in treatment [9].

Current Research and Clinical Trials

Several clinical trials are ongoing to explore new treatment options for sacral chordoma. These studies aim to improve our understanding of the disease and identify more effective therapies.

• Clinical trials: Researchers are currently studying experimental therapies, such as targeted therapy and immunotherapy, for the treatment of chordomas [7].
• Combination therapeutics: There is a growing interest in combination therapeutics within and across drug classes to treat residual or recurrent chordoma [12].

Surgery Remains the Primary Treatment

While drug therapy may be used in conjunction with surgery, it's essential to note that surgery remains the primary treatment for sacral chordoma. The way surgery is performed can significantly impact patient outcomes.

• En-bloc vertebrectomy: In some cases, en-bloc vertebrectomy, which involves removing the affected vertebrae, may be recommended [8].
• Surgical techniques: Improvement in surgical techniques has widened the range of treatment options for sacral chordoma [6].

References

[1] Stacchiotti et al. (2018) - Erlotinib treatment for recurrent refractory chordoma. [5] Case report describing a patient who received palliative radiotherapy and imatinib treatment upon recurrence after partial sacrectomy. [6] Improvement in surgical techniques has widened the range of treatment options for sacral chordoma. [7] Researchers are currently investigating experimental therapies, such as targeted therapy and immunotherapy, for the treatment of chordomas. [8] En-bloc vertebrectomy may be recommended in some cases. [9] Imatinib has been shown to have some role in treating advanced chordoma. [12] Combination therapeutics within and across drug classes are being explored to treat residual or recurrent chordoma.

Differential Diagnosis of Sacral Chordoma

Sacral chordoma, a rare type of bone tumor, can be challenging to diagnose due to its similarity with other conditions. The differential diagnosis for sacral chordoma includes various benign and malignant entities that should be considered in the diagnostic process.

Common Differential Diagnoses:

• Benign notochordal cell tumor: A rare, non-cancerous tumor that can occur in the spine and pelvis.
• Chondrosarcoma: A type of cancer that affects cartilage-producing cells, often found in the bones of the pelvis and spine.
• Ecchordosis physaliphora: A rare, benign condition characterized by the presence of notochordal cells in the spinal cord.
• Meningioma: A non-cancerous tumor that arises from the meninges, the protective membranes surrounding the brain and spinal cord.
• Pituitary macroadenoma: A type of non-cancerous tumor that occurs in the pituitary gland, a small endocrine gland located at the base of the brain.
• Plasmacytoma: A rare, cancerous condition characterized by an abnormal proliferation of plasma cells, which are a type of white blood cell.

Other Conditions to Consider:

• Bone metastases: Cancer that has spread from another part of the body