SACROCOCCYGEAL CHORDOMA-AN INTERESTING SURGICAL CONNUNDRUM CAUSING LARGE BOWEL OBSTRUCTION

70 year old gentleman presented with complaints of low backache for 6 months ,mass abdomen for 3 months and abdominal distension for 1 month.On examination,per abdomen-hard immobile mass palpable in the lower abdomen ,lower limit not palpable.Per rectalhard extramucosal mass palpable in the posterior wall of rectum pushing it anteriorly,upper limit not palpable.Local examination -hard immobile mass of 6x6 cm palpable in the sacral region with no fixity to skin.CECT Abdomen and Pelvis - Expansile lytic lesion confined to sacrum involving the surrounding soft tissues, rectum appears to be displaced anteriorly suggestive of SACRAL CHORDOMA.Trucut Biopsy suggestive of CHORDOMA.Surgery-Pre-sacral dissection,Abdomino-perineal resection with end colostomy,Partial Sacral (S3, S4, S5) and coccyx resection followed by anatomical closure of the defect.HPE report was CHORDOMA (conventional type) with infilteration into rectum.Post operative radiotherapy was given and on regular followup.K