Extract
Primary neurofibrosarcomas of the sacrum are rare and have been
reported only sporadically in the
literature1-3.
Because of the anatomic location, sacral tumors are often diagnosed only when
they have reached a large size involving neighboring structures, thus limiting
the potential for a curative resection. The treatment of choice for aggressive
sacral tumors is radical resection. Large sacral tumors require extensive
surgery to achieve adequate margins, and reconstruction to provide stability
between the spine and pelvis is a challenging problem. The complete removal of
the sacrum leaves the lumbopelvic complex so unstable that, without
reconstruction, a prolonged period of pain and rehabilitation is the usual
result4-6.
Descriptions of methods to reconstruct the pelvis after sacrectomy have
included the use of autologous bone grafts, allografts, autoclaved parts of
the resected sacrum, or metal
prostheses7-17.
We report the case of a patient with a large primary neurofibrosarcoma in the
sacrum and describe the technique we used for extended total en bloc
sacrectomy and primary reconstruction with use of structural tibial
allografts. After five years of follow-up, the patient was disease-free and
walking independently. Our patient was informed that data concerning the case
would be submitted for publication.