Sacrococcygeal chordoma

Sacrococcygeal chordoma is a rare disease indicated by a low-grade malignant tumor arising from the remains of the fetal notochord. The tumor is characterised by slow growth with invasion and compression of adjacent structures. Because of its location, it is nearly impossible to extirpate completely. Seven cases of sacrococcygeal chordoma were treated at Chang Gung Memorial Hospital, Division of Colon and Rectal Surgery. Five of the seven patients were male, and two were female. Their ages varied from 43 to 69 years old. Local or radicular pain were the common symptoms, of 0.5 to 36 months duration. All of the chordomas were detectable by digital examination, aided by other radiographic study. As for operative methods, the abdominal/sacral approach was used in six cases; and the abdominal approach was chosen in one case. All the patients experienced post-operative complications. Complete resection of the tumor was difficult. Although radiotherapy was also used, recurrence still developed in each case. Only 4 of 7 patients alived, with recurrence, from 23 to 38 months after resection. Repeated excision of a recurring tumor, in conjunction with irradiation, remains the treatment-of-choice.