Sacral chordoma : A review of literature

Chordoma is a rare malignant tumor with predilection for the sacrum. A favorable outcome depends on early diagnosis and surgical excision with tumor free margins. Aim: To review the incidence and prevalence of sacral chordoma and the appropriate surgical management and formulate a criteria for early diagnosis. Materials and methods: Thirty eight articles on the subject of sacral chordoma and extrapolated data of clinical and surgical significance. Results: The commonest presenting feature in patients with sacral chordoma was lower back pain which was worse on sitting and up to a third of these patients had associated urinary tract infections, constipation or symptoms of disc herniation. The hallmark of sacral chordoma is lower back pain with poor response to nonsteroidal anti-inflammatory drugs. Disease free eradication in chordoma is rare and not without neurological deficit. The common sacral levels involved ie. S2,3 have to be sacrificed to achieve adequate margins4. Whilst wide excision via posterior surgery shows a decrease in recurrence, the overall survival still remains low.