Valerio Pipola, Marco Girolami, Riccardo Ghermandi, Giuseppe Tedesco, Gisberto Evangelisti, Alessandro Gasbarrini


November 2018, Volume 27, Issue 12, pp 3059 - 3063 Grand Rounds Read Full Article 10.1007/s00586-017-5438-3

First Online: 25 January 2018

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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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