Cryosurgery in the excision of a giant local recurrent sacral chordoma: a case report and literature review

Abstract

Purpose

Chordoma is a low-grade malignant tumor with recurrence and metastasis tendency that originates from embryonic notochordal remnants. The sacrococcygeal region is the most commonly involved site. The aim of this paper is to report the results of the use of cryosurgery in the excision of a giant recurrent sacral chordoma and review of pertinent literature.

Methods

A 64 years old female patient with a locally recurrent sacral chordoma came to our attention after ten interventions performed at another institute. A surgical treatment was performed using argon cryosurgery.

Results

In this case, it was not possible to perform a marginal or wide excision, but it was intralesional with the removal of three major blocks. The fragments sent for the histological analysis measured total 35 × 30 × 8 cm with a weight of 4.260 g.

Conclusions

Given the gelatinous structure of the tumor and the possibility of contamination of operatory field, cryosurgery may be indicated when previous surgeries and the dimensions of tumor mass do not allow a resection with negative margins improving radiotherapy efficacy in the local control of tumor.

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Acknowledgements

The authors thank Carlo Piovani and Cristiana Griffoni for their helpful collaboration in imaging storage and data management.

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No funds were received in support of this study.

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Correspondence to Valerio Pipola.

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Pipola, V., Girolami, M., Ghermandi, R. et al. Cryosurgery in the excision of a giant local recurrent sacral chordoma: a case report and literature review. Eur Spine J 27, 3059–3063 (2018). https://doi.org/10.1007/s00586-017-5438-3

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Keywords

  • Local recurrent chordoma
  • Sacral chordoma
  • Cryosurgery
  • Cryotherapy