Sacral Chordoma

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In the present paper, the writers offer another authentic case of chordoma to add to the rather meagre number now reported. A review of the literature has revealed accounts of only slightly more than eighty cases of all varieties. Most of these have been situated, as was this one, in the sacral area, the next most frequent site being the spheno-occipital region, although in the past few years some cases occurring along the spine at various levels have been reported. Probably, chordoma is not so rare as the number of reported cases indicates, many such tumors being either overlooked or incorrectly diagnosed.

History of the Case. This patient was a man aged forty-one, a manufacturer, who came to the clinic September 10, 1929, complaining of pain in the lower part of his back. This pain began in December, 1928. It was very mild at first, but increased slowly in intensity. It was of a constant boring character not affected by activity, and interfered with the patient's sleep. Heat, aspirin, and periods of rest had failed to give relief and after months of annoying and unrelievable pain in the lower spine, occasionally radiating down the left leg, a consultation was sought.

The findings on physical, laboratory, and x-ray examinations were negative, except for a tender area the size of a fifty-cent piece over the lower third of the sacrum exactly in the mid-line. This area could be definitely delimited, and neither pressure over the surrounding parts nor manipulation of the lumbosacral or sacro-iliac joints produced any pain. . .