Surgical treatment of malignant tumours of the sacrum.

AIMS: We assessed the results of surgical treatment of malignant sacral tumours and aimed to supply information on incidence and distribution of these lesions.

METHODS: Forty-six malignant cases out of 65 tumours of the sacrum were assessed retrospectively. Three of the patients did not accept treatment. Surgical treatment was applied to 23 (65.2%) of the remaining 43 patients. Surgical techniques used were resection and PMMA (polymethylmethacrylate) application through a posterior approach, sacral reconstruction, and resection through a combined posterior and anterior approach.

RESULTS: Twelve of the lesions were primary while 34 were secondary. Among the primary sacrum tumours, the most common was chordoma (six cases, forming 9.2% of all the sacral lesions). Of a secondary sacral lesions, nine cases of breast carcinoma were found, forming the most common group. The recurrence rate was 23.3%.

CONCLUSIONS: Chordoma was the most common primary sacral tumour, but found no incidence of giant cell tumour which has been previously reported as the second most common primary sacral tumour. We believe the posterior approach for resection of the tumour is sufficient in most instances and lumbopelvic instability must be prevented by reconstructive procedures.