75 year old male. There is presence of an expansile 14 x 10 x 10 cm sized mass noted in sacrococcygeal region involving sacrum sparing S1 vertebra with associated soft tissue component.It involves sacral foramina and sacral spinal canal. It is hypointense on T1W , hyperintese on T2W with lobulated margins and internal sepatated appearance. Anteriorly, large presacral soft tissue component indents the posterior wall of rectum with preserved intervening fat plane. Laterally, the mass infiltrates paraspinous muscles and left gluteus medius muscle and appears to be infiltrating left sciatic fossa with involvement of left sciatic nerve in gluteal region. Posteriorly it extends upto subcutaneous fat . On MRI, sacrococcygeal chordomas are lobulated tumors, typically with low to intermediate signal intensity on T1-weighted images and heterogeneous high signal intensity on T2-weighted images. Case by Dr Sumer Sethi, Dr Swati Shah, Dr Ajay Garg, Dr Harwinder Bakshi (Orthopedician)
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