Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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10-MARCH-2008 ABDEL-KAREEM MAHMOUD AL-SHBOOL 55
YEARS PROVISIONAL CHORDOMA OF THE RIGHT SIDE OF THE SACRUM COMPRESSING THE
RIGHT S2-3 AND S4 ROOTS.
The patient came to the
clinic 08-March-2008 complaining right sciatica
for two months with numbness right S1 territory.
The pain increases during night.
cervical spine done 26-February-2008 showing
huge sacral mass in the right side with
destruction of bone at the level of S2-3-4 right
On examination: the patient
is dragging his right leg and has scoliotic stance.
There is weak dorsi and planterflexion right
foot. SLRS was 70 degrees in the right with
Bone scan was confirming the
absence of MTS.
Midline incision over the
sacrum and the using drilling the right S2 and
S3 were identified. The mass was pushing them
medially and it was grayish violet in color and
friable in consistency and highly vascular. It
was possible to remove it radically and the
periosteum of the sacrum was not involved. The
bone cavity was filled with healthy bone
harvested from the surround and muscles were
used to fulfill the cavity. An external drain
was inserted with ready-vac drain and negative
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the right foot.
The final histologic studies
confirmed the presence of pasmacytoma of
extramedullary type and Bence-Jones proteins
were negative in daily urine collection with ESR
The patient was advised to
undergo hematologic workup and to undergo
radiotherapy locally with 40-45 Kg over 6 weeks.
Plasmocytomas are frequent in
localization in the sacrum.