Chondromyxoid fibroma of the sacrum: A case report and literature review.
BACKGROUND
Chondromyxoid fibroma (CMF) is an extremely rare, benign cartilaginous tumor that makes up <0.5% of all bone tumors, typically presenting in the second or third decade of life. CMF of the sacrum is exceedingly rare, with only seven documented cases reported in the neurosurgical literature.


METHODS
We report a case of a 35-year-old female with a 3 month history of lower back pain after sustaining a fall on her sacrum/coccyx presenting with a progressive complaint of localized lower back pain, occasional urinary retention without incontinence, gluteal hypesthesia, and pressure below the gluteal crease. Imaging demonstrated a large, expansile enhancing soft-tissue lesion involving the sacrum, distal to the S2-3 disc space. The tumor was removed with partial sacrectomy for open en bloc resection with partial nerve sparing. The patient was found at 1.5-year follow-up with the improvement of symptoms, no recurrence, and no residual neurologic dysfunction.


CONCLUSIONS
Sacral CMF is a rare clinical entity that may mirror more aggressive sacral pathology, including chordoma, in both clinical presentation and imaging characteristics. A review of the available literature regarding diagnosis, surgical management options, and prognosis for sacral CMF is provided.
Department of Neurosurgery, Arrowhead Regional Medical Center, Colton, CA, USA; Department of Surgery, Division of Neurosurgery, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, USA; Department of Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Tanya
T
Minasian
Department of Surgery, Division of Neurosurgery, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, USA.
Chad
C
Claus
Department of Neurosurgery, Arrowhead Regional Medical Center, Colton, CA, USA; Department of Surgery, Division of Neurosurgery, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, USA; Department of Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Omid R
OR
Hariri
Department of Pathology, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Zhe
Z
Piao
Department of Neurosurgery, Arrowhead Regional Medical Center, Colton, CA, USA.
Syed A
SA
Quadri
Department of General Surgery, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Robert
R
Yuhan
Department of Plastic Surgery, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Darren
D
Leong
Department of Neurosurgery, Arrowhead Regional Medical Center, Colton, CA, USA; Department of Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, CA, USA.
Vartan
V
Tashjian
Chondromyxoid fibroma; chondrosarcoma; sacral chordomas; sacrectomy; sacrum