Skip to main content
SpringerLink
Log in

Histopathology of Sacral Tumors and Pseudotumors

  • Chapter
  • First Online:
Tumors of the Sacrum

  • 850 Accesses

Abstract

The sacrum is composed of bone, cartilage, soft mesenchymal tissue, bone marrow, and notochordal remnants, which give rise to tumors or pseudotumors. Tumors of the sacrum include primary and metastatic/systemic origin. The primary tumors consist of malignant and benign entities. Systemic diseases include metastases and hematopoietic malignancies such as lymphoma, multiple myeloma, or plasmacytoma. The incidence of sacral tumors and pseudotumors at the Rizzoli institute is described in the epidemiology chapter of this book. Personal communication with Dr. Xiaohui Niu, Professor and Chair of the Department of Orthopedic Oncology Surgery of the Jishuitan (JST) Hospital in Beijing, China, the largest and a premier Orthopedic Oncology hospital in China, also confirms the most frequently occurring sacral tumors (Table 7.1). This data is retrieved from the JST epidemiology website of musculoskeletal tumors (www.sarcoma-jst.net) based on a collection of 18, 419 cases [1]. In this chapter, the histopathology as well as pertinent ancillary diagnostic, prognostic, and predictive information of these common tumors and pseudotumors will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Xu H, Seifert RP, Niu X, Li Y, Bui MM. The establishment and utility of a free online database of primary bone tumors. Pathol Oncol Res. 2016;22(1):129–33. PubMed PMID: 26377426.

    Article  PubMed  Google Scholar 

  2. Thornton E, Krajewski KM, O’Regan KN, Giardino AA, Jagannathan JP, Ramaiya N. Imaging features of primary and secondary malignant tumours of the sacrum. Br J Radiol. 2012;85(1011):279–86. PubMed PMID: 22167504. Pubmed Central PMCID: PMC3473982.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Fletcher CDM, World Health Organization, International Agency for Research on Cancer. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC Press; 2013. p. 468.

    Google Scholar 

  4. Diel J, Ortiz O, Losada RA, Price DB, Hayt MW, Katz DS. The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics. 2001;21(1):83–104. PubMed PMID: 11158646.

    Article  CAS  PubMed  Google Scholar 

  5. Ha AS, Chew FS. Imaging of sacral masses: self-assessment module. AJR Am J Roentgenol. 2010;195(3 Suppl):S32–6. PubMed PMID: 20729410.

    Article  PubMed  Google Scholar 

  6. Vujovic S, Henderson S, Presneau N, Odell E, Jacques TS, Tirabosco R, et al. Brachyury, a crucial regulator of notochordal development, is a novel biomarker for chordomas. J Pathol. 2006;209(2):157–65. PubMed PMID: 16538613.

    Article  CAS  PubMed  Google Scholar 

  7. Chen K, Mo J, Zhou M, Wang G, Wu G, Chen H, et al. Expression of PTEN and mTOR in sacral chordoma and association with poor prognosis. Med Oncol. 2014;31(4):886. PubMed PMID: 24535608

    Article  PubMed  Google Scholar 

  8. Mobley BC, McKenney JK, Bangs CD, Callahan K, Yeom KW, Schneppenheim R, et al. Loss of SMARCB1/INI1 expression in poorly differentiated chordomas. Acta Neuropathol. 2010;120(6):745–53. PubMed PMID: 21057957.

    Article  CAS  PubMed  Google Scholar 

  9. Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, et al. The clinical approach towards chondrosarcoma. Oncologist. 2008;13(3):320–9. PubMed PMID: 18378543.

    Article  PubMed  Google Scholar 

  10. Amary MF, Bacsi K, Maggiani F, Damato S, Halai D, Berisha F, et al. IDH1 and IDH2 mutations are frequent events in central chondrosarcoma and central and periosteal chondromas but not in other mesenchymal tumours. J Pathol. 2011;224(3):334–43. PubMed PMID: 21598255.

    Article  CAS  PubMed  Google Scholar 

  11. Taylor BS, Barretina J, Maki RG, Antonescu CR, Singer S, Ladanyi M. Advances in sarcoma genomics and new therapeutic targets. Nat Rev Cancer. 2011;11(8):541–57. PubMed PMID: 21753790. Pubmed Central PMCID: PMC3361898.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Evans HL, Ayala AG, Romsdahl MM. Prognostic factors in chondrosarcoma of bone: a clinicopathologic analysis with emphasis on histologic grading. Cancer. 1977;40(2):818–31. PubMed PMID: 890662.

    Article  CAS  PubMed  Google Scholar 

  13. Henderson-Jackson EB, Bui MM. Molecular pathology of soft-tissue neoplasms and its role in clinical practice. Cancer Control. 2015;22(2):186–92. PubMed PMID: 26068763.

    PubMed  Google Scholar 

  14. Surdez D, Benetkiewicz M, Perrin V, Han ZY, Pierron G, Ballet S, et al. Targeting the EWSR1-FLI1 oncogene-induced protein kinase PKC-beta abolishes Ewing sarcoma growth. Cancer Res. 2012;72(17):4494–503. PubMed PMID: 22930730.

    Article  CAS  PubMed  Google Scholar 

  15. Delattre O, Zucman J, Plougastel B, Desmaze C, Melot T, Peter M, et al. Gene fusion with an ETS DNA-binding domain caused by chromosome translocation in human tumours. Nature. 1992;359(6391):162–5. PubMed PMID: 1522903.

    Article  CAS  PubMed  Google Scholar 

  16. Coppola D. Mechanisms of oncogenesis: an update on tumorigenesis. Dordrecht: Springer; 2010. xii, 314p.

    Google Scholar 

  17. Coppola D. Molecular pathology and diagnostics of cancer. New York: Springer; 2013.

    Google Scholar 

  18. Llauger J, Palmer J, Amores S, Bague S, Camins A. Primary tumors of the sacrum: diagnostic imaging. AJR Am J Roentgenol. 2000;174(2):417–24. PubMed PMID: 10658718.

    Article  CAS  PubMed  Google Scholar 

  19. Rodallec MH, Feydy A, Larousserie F, Anract P, Campagna R, Babinet A, et al. Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics. 2008;28(4):1019–41. PubMed PMID: 18635627.

    Article  PubMed  Google Scholar 

  20. Murphey MD, Andrews CL, Flemming DJ, Temple HT, Smith WS, Smirniotopoulos JG. From the archives of the AFIP. Primary tumors of the spine: radiologic pathologic correlation. Radiographics. 1996;16(5):1131–58. PubMed PMID: 8888395.

    Article  CAS  PubMed  Google Scholar 

  21. Olsen SH, Thomas DG, Lucas DR. Cluster analysis of immunohistochemical profiles in synovial sarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma. Mod Pathol. 2006;19(5):659–68. PubMed PMID: 16528378.

    Article  CAS  PubMed  Google Scholar 

  22. Rossi S, Orvieto E, Furlanetto A, Laurino L, Ninfo V, Dei Tos AP. Utility of the immunohistochemical detection of FLI-1 expression in round cell and vascular neoplasm using a monoclonal antibody. Mod Pathol. 2004;17(5):547–52. PubMed PMID: 15001993.

    Article  CAS  PubMed  Google Scholar 

  23. Dodd L, Bui MM. Atlas of soft tissue and bone pathology: with histologic, cytologic, and radiologic correlations. New York: Demos Medical; 2015. viii, 419p.

    Google Scholar 

  24. Anninga JK, Gelderblom H, Fiocco M, Kroep JR, Taminiau AH, Hogendoorn PC, et al. Chemotherapeutic adjuvant treatment for osteosarcoma: where do we stand? Eur J Cancer. 2011;47(16):2431–45. PubMed PMID: 21703851.

    Article  CAS  PubMed  Google Scholar 

  25. Czerniak B, Dorfman HD. Dorfman and Czerniak’s bone tumors. 2nd ed. Philadelphia: Elsevier; 2016.

    Google Scholar 

  26. Goldblum JR, Folpe AL, Weiss SW, Enzinger FM, Weiss SW. Enzinger and Weiss’s soft tissue tumors. 6th ed. Philadelphia: Saunders/Elsevier; 2014. xiv, 1155p.

    Google Scholar 

  27. Disler DG, Miklic D. Imaging findings in tumors of the sacrum. AJR Am J Roentgenol. 1999;173(6):1699–706. PubMed PMID: 10584822.

    Article  CAS  PubMed  Google Scholar 

  28. Wu H, Zhang L, Shao H, Sokol L, Sotomayor E, Letson D, et al. Prognostic significance of soft tissue extension, International Prognostic Index, and multifocality in primary bone lymphoma: a single institutional experience. Br J Haematol. 2014;166(1):60–8. PubMed PMID: 24673481.

    Article  PubMed  Google Scholar 

  29. Wu H, Bui MM, Leston DG, Shao H, Sokol L, Sotomayor EM, et al. Clinical characteristics and prognostic factors of bone lymphomas: focus on the clinical significance of multifocal bone involvement by primary bone large B-cell lymphomas. BMC Cancer. 2014;14:900. PubMed PMID: 25465716. Pubmed Central PMCID: PMC4265495.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Nakamura M, Tsushima K, Yasuo M, Yamazaki Y, Honda T, Koizumi T, et al. Angiosarcoma with sacral origin metastasizing to the lung. Intern Med. 2006;45(15):923–6. PubMed PMID: 16946576.

    Article  PubMed  Google Scholar 

  31. Chow LT, Lui YH, Kumta SM, Allen PW. Primary sclerosing epithelioid fibrosarcoma of the sacrum: a case report and review of the literature. J Clin Pathol. 2004;57(1):90–4. PubMed PMID: 14693846. Pubmed Central PMCID: PMC1770169.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Dv R, Dm K, Vanel D, Campanacci L, Iv B, Ag T, et al. Malignant solitary fibrous tumor of the sacrum: a case report. J Cancer Res Ther. 2015;3(4):52–5. English.

    Article  Google Scholar 

  33. Huang L, Xu J, Wood DJ, Zheng MH. Gene expression of osteoprotegerin ligand, osteoprotegerin, and receptor activator of NF-kappaB in giant cell tumor of bone: possible involvement in tumor cell-induced osteoclast-like cell formation. Am J Pathol. 2000;156(3):761–7. PubMed PMID: 10702390. Pubmed Central PMCID: PMC1876848.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Shimada Y, Hongo M, Miyakoshi N, Kasukawa Y, Ando S, Itoi E, et al. Giant cell tumor of fifth lumbar vertebrae: two case reports and review of the literature. Spine J. 2007;7(4):499–505. PubMed PMID: 17630149.

    Article  PubMed  Google Scholar 

  35. Bidwell JK, Young JW, Khalluff E. Giant cell tumor of the spine: computed tomography appearance and review of the literature. J Comput Tomogr. 1987;11(3):307–11. PubMed PMID: 3608560.

    Article  CAS  PubMed  Google Scholar 

  36. Randall RL. Giant cell tumor of the sacrum. Neurosurg Focus. 2003;15(2):E13. PubMed PMID: 15350044.

    Article  PubMed  Google Scholar 

  37. Niu X, Xu H, Inwards CY, Li Y, Ding Y, Letson GD, et al. Primary bone tumors: epidemiologic comparison of 9200 patients treated at Beijing Ji Shui Tan Hospital, Beijing, China, with 10 165 patients at Mayo Clinic, Rochester, Minnesota. Arch Pathol Lab Med. 2015;139(9):1149–55. PubMed PMID: 25978765.

    Article  PubMed  Google Scholar 

  38. Muheremu A, Huang Z, Niu X. Treatment for giant cell tumor of the spine metastasizing to the lung: A report of two cases and a literature review. Oncol Lett. 2015;9(3):1321–6. PubMed PMID: PMC4315077.

    PubMed  Google Scholar 

  39. Payer M. Neurological manifestation of sacral tumors. Neurosurg Focus. 2003;15(2):E1. PubMed PMID: 15350032.

    Article  PubMed  Google Scholar 

  40. Nonaka D, Chiriboga L, Rubin BP. Sox10: a pan-schwannian and melanocytic marker. Am J Surg Pathol. 2008;32(9):1291–8. PubMed PMID: 18636017.

    Article  PubMed  Google Scholar 

  41. Pekmezci M, Reuss DE, Hirbe AC, Dahiya S, Gutmann DH, von Deimling A, et al. Morphologic and immunohistochemical features of malignant peripheral nerve sheath tumors and cellular schwannomas. Mod Pathol. 2015;28(2):187–200. PubMed PMID: 25189642.

    Article  CAS  PubMed  Google Scholar 

  42. Oliveira AM, Perez-Atayde AR, Inwards CY, Medeiros F, Derr V, Hsi BL, et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol. 2004;165(5):1773–80. PubMed PMID: 15509545. Pubmed Central PMCID: PMC3278819.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Bui MM, Smith P, Agresta SV, Cheong D, Letson GD. Practical issues of intraoperative frozen section diagnosis of bone and soft tissue lesions. Cancer Control. 2008;15(1):7–12. PubMed PMID: 18094656.

    PubMed  Google Scholar 

  44. Khalbuss WE, Parwani AV. Cytopathology of soft tissue and bone lesions. New York: Springer; 2011.

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA

    Marilyn M. Bui M.D., Ph.D. & Evita Henderson Jackson M.D.

  2. Department of Sarcoma, Moffitt Cancer Center, Tampa, FL, USA

    Marilyn M. Bui M.D., Ph.D. & Evita Henderson Jackson M.D.

  3. Department of Pathology, Jishuitan Hospital, Beijing, China

    Yi Ding M.D.

  4. Department of Medicine, University of Padua School of Medicine, Padua, Italy

    Angelo Paolo Dei Tos M.D.

Authors
  1. Marilyn M. Bui M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yi Ding M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Evita Henderson Jackson M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angelo Paolo Dei Tos M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marilyn M. Bui M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Padova, Italy

    Pietro Ruggieri

  2. Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Padova, Italy

    Andrea Angelini

  3. Department of Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy

    Daniel Vanel

  4. Laboratory of Experimental Oncology, Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy

    Piero Picci

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Bui, M.M., Ding, Y., Jackson, E.H., Tos, A.P.D. (2017). Histopathology of Sacral Tumors and Pseudotumors. In: Ruggieri, P., Angelini, A., Vanel, D., Picci, P. (eds) Tumors of the Sacrum. Springer, Cham. https://doi.org/10.1007/978-3-319-51202-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-51202-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51200-6

  • Online ISBN: 978-3-319-51202-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation