The types and clinical characteristics of sacral tumors

English Keywords:Sacrum  Tumor  Type  Diagnosis

English Abstract:

  【Abstract】 Objective：To investigate the type and clinical characteristics of sacral tumors.Method：Clinical documents，image data and pathological diagnoses of 445 sacral tumors treated in our center between 1998 and 2009 were reviewed retrospectively.There were 228 males and 217 females，with the average age of 46.4 years.The chief complaints included pain in lower limbs or mass in 352 and 93 patients respectively.Result：351 cases had primary sacral tumors，including 174 males and 177 females，with the average age of 44.4 years.98 patients（average，55.7 years） were diagnosed as chordoma with higher involvement in males（62） than in females（33）.82 patients presented with sacrococcygeal pain and more than half of them had sciatica. Lower sacrum（S3-S5） was involved in 56 cases and S1-S5 or S2-S5 were involved in 39 cases.76 patients were diagnosed as neurogenic tumors，which included neurofibroma（43），schwannoma（24），and malignant schwannoma（9）.There were 36 males and 40 females，with the average age of 47.7 years.36 patients presented with sciatica and perineal numbness，11 patients had painless mass and the other 20 were identified due to other causes.Among 67 benign neurogenic tumors，54 were originated from S1-S3 nerves，3 from S4-S5 nerves and 11 from the presacral space without caudal involvement.Giant cell tumor was found in 60 patients，which included 24 males and 36 females，with an average age of 32 years.Upper sacrum（S1-S2） was involved firstly.There were 56 patients（average，37.7 years） diagnosed as other primary benign bone tumors，which included 24 cases of teratomas，epidermoid cyst or dermoid cyst.Other malignant tumors，including chondrosarcoma （17），Ewing′s sarcoma/PNET（14），multiple myeloma（12），lymphoma（6） and osteosarcoma（6） were found in 64 patients.Metastatic tumors were confirmed in 94 patients with origin of undefined in 23 cases，lung cancer in 13 cases，kidney cancer in 12 cases and colorectal cancer in 10 cases.There were 54 males and 40 females with an average age of 54.1 years.Conclusion：Approximately 2/3 primary sacral tumors are chordoma，neurogenic tumor or giant cell tumor.Patients presenting with low back pain，sciatica and caudal equine function abnormality should be considered to have sacral tumor，which can be preliminarily diagnosed based on age，lesion location and characteristic image findings.