Rehman Omer Farooq, Hussain Amer K, Ummair Mohammad, Umair Musab, Waqar Muhammad
Urology, Armed Forces Institute of Urology, Rawalpindi, PAK.
Surgery, Our Lady of Lourdes Hospital, Drogheda, Cavan, IRL.
Cureus. 2020 Dec 15;12(12):e12099. doi: 10.7759/cureus.12099.
Sacral giant cell tumors (GCTs) are rare entities that exhibit slow progressive growth and become clinically apparent when they reach a considerable size. The current case report discusses the presentation, investigation, and management of a young male patient diagnosed with a large sacral mass. A 17-year-old male patient presented with uremia, bilateral lumbar pain, and severe weakness of his lower extremities. Imaging revealed a midline sacral mass causing bilateral upper tract obstruction. The patient underwent bilateral nephrostomies followed by a partial en bloc sacrectomy and curettage of the tumor bulk. Histopathology revealed a giant cell tumor of the sacrum. Postoperatively, the patient received adjuvant radiotherapy and rehabilitation for his neurological symptoms. Sacral GCTs are essentially benign but behave like a malignant tumor in view of frequent recurrences and reports of malignant transformation. Surgery with wide local excision remains the ideal modality for complete clearance of sacral tumors. Nevertheless, limitations include their large size, difficult operative access, risk of fatal intraoperative bleeding, and inevitable high postoperative morbidity.
骶骨巨细胞瘤（GCTs）是一种罕见的疾病，生长缓慢，当肿瘤长到相当大的尺寸时才会在临床上显现出来。本病例报告讨论了一名被诊断为巨大骶骨肿物的年轻男性患者的临床表现、检查及治疗情况。一名17岁男性患者出现尿毒症、双侧腰痛及双下肢严重无力。影像学检查显示中线骶骨肿物导致双侧上尿路梗阻。患者先行双侧肾造瘘术，随后行肿瘤整块部分切除及刮除术。组织病理学检查显示为骶骨巨细胞瘤。术后，患者接受了辅助放疗及针对神经症状的康复治疗。骶骨巨细胞瘤本质上是良性的，但鉴于其频繁复发及恶性转化的报道，其行为类似恶性肿瘤。广泛局部切除手术仍是彻底清除骶骨肿瘤的理想方式。然而，其局限性包括肿瘤体积大、手术入路困难、术中致命出血风险以及术后不可避免的高发病率。
