title: Management and retrospective analysis of primary and metastatic sacral tumors and infections: evaluation with 73 cases.
abstract: OBJECTIVE
  This study aims to evaluate the clinicopathologic characteristics and treatment modalities of 73 patients with benign and malign sacral tumors and infections from a single institution.
  
  
  METHODS
  Seventy-three patients (42 males, 31 females; mean age 48.9 years), who were treated between July 1991 and December 2013, with benign, malign tumors, and infections of the sacrum were retrospectively analyzed for a mean follow-up period of 25.4 months, and a review of the literature was conducted. While 36 patients were treated surgically, 37 were treated medically. Fifty-four patients were diagnosed with malign, and 19 with benign or infectious tumors.
  
  
  RESULTS
  In 54 patients with malign tumors, metastasis was the most common diagnosis in 20 patients followed by chordoma in 11, and multiple myeloma in 10 patients. Common benign lesions were osteomyelitis in four patients, and giant cell tumor and schwannoma in three patients each. Local recurrence was most commonly observed in the chordoma and chondrosarcoma groups with a rate of 50%. Seven patients including five with metastatic disease, one with chondrosarcoma, and one with chordoma died during follow-ups. While urinary and anal incontinence developed in seven patients after sacral resection, deep infection was reported in four, and superficial infection was reported in two patients.
  
  
  CONCLUSIONS
  Because of the high complication rates in malign sacral tumors, we should perform wide resections with partial or total sacrectomy. Chordoma and chondrosarcoma patients should be screened closely due to a possible recurrence risk after sacrectomy while preserving the nerve roots as possible. Aggressive curettage should be combined with adjuvant methods in benign lesions due to high recurrence rates in sacral localization.
authors.affiliation: Department of Orthopedics and Traumatology, Oncology Training and Research Hospital, 06200 Demetevler, Ankara, Turkey. smuratark@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Arıkan
authors.forename: Güray
authors.initials: G
authors.lastname: Togral
authors.forename: Aşkın Esen
authors.initials: AE
authors.lastname: Hastürk
authors.forename: Erdem
authors.initials: E
authors.lastname: Aktaş
authors.forename: Safak
authors.initials: S
authors.lastname: Güngör
mesh_terms: D000328:Adult; D002813:Chondrosarcoma / Q000628:therapy*; D002817:Chordoma / Q000628:therapy*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000628:therapy*; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000628:therapy*; D010019:Osteomyelitis / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012447:Sacrum; D013125:Spinal Neoplasms / Q000556:secondary / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology