Riding the Tail of a Rare Tumor: Sacral Chordoma Insights

Chordoma is a rare, slow-growing malignant tumor of notochordal origin, accounting for 1%–4% of primary skeletal neoplasms, most commonly in the sacrococcygeal region. We report a 44-year-old male with dull, progressive sacrococcygeal pain and numbness for 6 months. Imaging showed a lytic, metabolically active sacral–coccygeal lesion, and surgical excision yielded a 6 cm × 5 cm × 3.5 cm gelatinous mass. Histology revealed physaliferous cells in a lobulated, myxoid background, confirming conventional chordoma, with brachyury positivity. The tumor involved the posterior margin. Given their aggressive, recurrent nature, chordomas require complete excision, radiotherapy, and multidisciplinary evaluation for optimal outcomes.