Nódulo sacro en paciente joven: ¿y si no es un sinus pilonidal? Un caso al respecto

[Sacral nodule in a young patient: what if it is not a pilonidal sinus? A case about it]

José Felipe Reoyo Pascual1, Lucia Polanco Álvarez1

1. Hospital Universitario de Burgos España;

Publicado: 2022-08-30

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Resumen

El cordoma es un tumor óseo muy poco frecuente de origen notocordal. El comportamiento biológico variable y el sitio anatómico donde aparece hacen que tenga un tratamiento complejo que exige un abordaje multidisciplinar. Por ello un diagnóstico precoz formando parte del diagnóstico diferencial de un nódulo sacro hacen que mejore considerablemente el pronóstico del paciente. Presentamos el caso de un paciente de 46 años, intervenido por sinus pilonidal paucisintomático, siendo la anatomía patológica de la pieza quirúrgica informada como cordoma sacro. Este hallazgo pone en marcha un comité multidisciplinar que acaba indicando intervención por parte de Neurocirugía.

A la luz del caso presentado, consideramos que el cordoma debe formar parte del abanico de diagnósticos diferenciales del médico y cirujano general, lo cual repercutirá favorablemente en el diagnóstico del paciente.


Abstract

Chordoma is a very rare bone tumor of notochordal origin. The variable biological behavior and the anatomical site where it appears make it a complex treatment that requires a multidisciplinary approach. Therefore, an early diagnosis as part of the differential diagnosis of a sacral nodule considerably improves the patient's prognosis. We present the case of a 46-year-old patient, operated for paucisymptomatic pilonidal sinus, being the pathological anatomy of the surgical specimen reported as sacral chordoma. This finding set in motion a multidisciplinary committee that ended up indicating intervention by Neurosurgery.

In the light of the case presented, we consider that chordoma should form part of the range of differential diagnoses of the general physician and surgeon, which will have a favorable impact on the patient's diagnosis.

Citas

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[2] Yamaguchi T, Yamato M, Saotome K. First histologically confirmed case of classic chordoma arising in precursor benign notochordal lesion: Difeferen tial diagnosis of benign and malignant notochordal lesions. Skeletal Radiol 2002; 31:413-418, DOI: https://doi.org/10.1007/s00256-002-0514-z

[3] Hoch BL, Nielsen GP, Liebsch NJ, et al.: Base of skull chordomas in children and adolescents: a clinicopathologic study of 73 cases. Am J Surg Pathol 30 (7): 811-8, 2006, DOI: https://doi.org/10.1097/01.pas.0000209828.39477.ab

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[5] Sebro R, DeLaney T, Hornicek F, et al.: Differences in sex distribution, anatomic location and MR imaging appearance of pediatric compared to adult chordomas. BMC Med Imaging 16 (1): 53, 2016, DOI: https://doi.org/10.1186/s12880-016-0149-5

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