Sacral Tumors
The sacrum is a large triangular bone at the lower end of the spine connecting the pelvis to the spine. Tumors developing in this region are rare but complex to diagnose and treat. Sacral tumors can be primary (starting here) or metastatic (spreading from other organs).
What Is a Sacral Tumor?
Types of Sacral Tumors
Primary Tumors
- Chordoma: The most common primary tumor arising from notochord remnants. Grows slowly but is locally aggressive.
- Giant cell tumor: Locally aggressive, benign character
- Chondrosarcoma: Malignant tumor from cartilage
- Osteosarcoma: Malignant bone tumor
- Ewing sarcoma: Seen in young patients
- Schwannoma: Benign nerve-origin tumor
- Sacral meningioma: Rarely seen
Metastatic Tumors
Spread from prostate, breast, lung, kidney, and thyroid cancers is common.
Symptoms
- Low back and hip pain: Slow onset, progressive
- Radiating leg pain: Sciatica-like
- Mass in sacral region: Palpable swelling
- Bladder dysfunction: Incontinence, retention
- Bowel dysfunction: Constipation, incontinence
- Sexual dysfunction: Erectile dysfunction
- Leg weakness: Due to nerve compression
- Perineal numbness: Saddle anesthesia
Diagnosis
- Pelvic MRI: Tumor size, extent, nerve and organ involvement
- CT scan: Bone destruction assessment
- PET-CT: Metastasis screening
- Biopsy: Tissue sample for histopathological diagnosis
- Angiography: Preoperative embolization planning for vascular tumors
Treatment
Surgical Treatment
Primary treatment method is surgical resection:
- En bloc resection: Removal of tumor with healthy tissue margins
- Posterior approach: For tumors below S3
- Combined anterior-posterior approach: For large tumors
- Sacrectomy: Partial or total removal of sacrum
Surgical Challenges
- Preserving sacral nerve roots
- Preserving bladder and bowel function
- Proximity to major blood vessels
- Maintaining pelvic stability
Radiotherapy
- As adjunct to surgery or alone
- Proton therapy (effective for chordoma)
- Carbon ion therapy
Chemotherapy
Used for Ewing sarcoma and some metastatic tumors.
Post-Operative Care
- Hospital stay: 7-14 days
- Rehabilitation: Intensive physical therapy
- Bladder/bowel training: If function is lost
- Follow-up: Regular MRI checks
Prognosis
Prognosis depends on tumor type and surgical margins. Five-year survival for chordoma with en bloc resection is 60-80%. For metastatic tumors, treatment is palliative.
Why Choose Prof. Dr. Salim Şentürk?
Prof. Dr. Salim Şentürk has multidisciplinary approach and complex surgical experience in sacral tumor surgery.
Sacral Mass Evaluation
Schedule an appointment for tumor type determination with MRI and biopsy.
Frequently Asked Questions
Can I walk after sacral tumor surgery?
Depends on nerve preservation. Leg function is usually preserved in high sacral tumors.
Will my bladder function be affected?
Bladder dysfunction may develop depending on S2-S4 nerve root involvement. Adaptation is achieved with rehabilitation.
Other Treatments
Spine Surgery
Surgical treatment of spine and spinal cord diseases
Deformity Surgery
Deformity surgery is the surgical correction of scoliosis, kyphosis, and spinal imbalance. Effective treatment is achieved with modern techniques and implants. Prof. Dr. Salim Şentürk's expertise in complex deformity surgery.
Endoscopic Spine Surgery
Endoscopic spine surgery is a minimally invasive technique performed through an 8 mm incision. Same-day discharge and rapid recovery are possible for lumbar and cervical disc herniations. Prof. Dr. Salim Şentürk's endoscopic surgery expertise.
Peripheral Nerve Surgery
Peripheral nerve surgery treats nerve compressions, injuries, and tumors. Carpal tunnel, cubital tunnel, and nerve tumors are treated surgically. Prof. Dr. Salim Şentürk's nerve surgery expertise.
Reviewed by: Prof. Dr. Salim Şentürk, Neurosurgeon
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