A rare case of sacrococcygeal squamous cell carcinoma
Introduction: Sacrococcygeal neoplastic lesions are extremely rare. Primary benign or malignant lesion are lesser than 7% of all intraspinal lesions. Patients with sacral tumors present with non-specific symptoms, including pain, palpable mass, and neurologic deficits. Despite the advancement of i...
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| Main Authors: | , , , |
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| Format: | Proceeding |
| Language: | en |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/40943/3/A%20RARE%20CASE.pdf http://ir.unimas.my/id/eprint/40943/ https://morthoj.org/supplements/moa-2021/ |
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| Summary: | Introduction: Sacrococcygeal neoplastic lesions are extremely rare. Primary benign or malignant lesion
are lesser than 7% of all intraspinal lesions. Patients with sacral tumors present with non-specific
symptoms, including pain, palpable mass, and neurologic deficits. Despite the advancement of imaging
modalities, it is still a diagnostic and therapeutic challenge. Squamous cell carcinoma (SCC) of this area
is very rare. A few case reported with acquired condition or underlying congenital or developmental
remnants. A chronic sacrococcygeal pilonidal disease with SCC transformation is described by
Michalopoulos et al. Demirel AH et al reported the incident of SCC with underlying tailgut cyst in 73 yearold female. CT-scan and MRI is done to define the anatomic origin, extent, and radiologic features of a
given lesion. Biopsy is commonly performed to obtain histologic diagnosis. In this paper we report a
primary squamous cell carcinoma in this region.
Discussion: A 52 year-old lady who presented with five months history of painless right-sided sacral
swelling associated with right radicular pain, urinary incontinence and constipation. No constitutional
symptoms. The swelling is 8x8 cm in size, firm to hard consistency, non-mobile, smooth surface, illdefined border and not fixed to the overlying skin. Plain X-Ray of Pelvis revealed right sided sacrococcygeal expensile lytic lesion with ill-defined margin. CT-Scan of pelvis showed sacrococcygeal
heterogenous mass associated with bony destruction and compression on bladder and rectum. MRI
revealed aggressive sacrococcygeal mass with local bony invasion and sacral nerve root S2-S5
involvement. Biopsy was performed and HPE result was consistent with Squamous Cell Carcinoma
(SCC). Systemic staging showed metastases to bilateral lungs. Palliative Care was planned with multidisciplinary team involvement.
Conclusion: Sacrococcygeal Squamous Cell Carcinoma is very rare. Diagnosis remained challenging
even with advancement of imaging modalities. Biopsy is required to confirm tissue diagnosis. Treatment
requires multi-disciplinary team approach to ensure survival of the patient |
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