Sacral chordoma symptoms

Sacral chordoma is a type of tumor that occurs frequently in middle-aged and elderly people. It is rare for adolescents to develop it. Chordoma is common on both sides of the spine. The primary symptom of the tumor is obvious pain at the site of growth. The symptoms vary depending on the location of the tumor. For example, if it occurs at the base of the skull, headaches and neck pains often occur. There are also other situations, as described below.

1. Clinical symptoms depend on the location of the tumor: occipital and sphenoid tumors may cause headaches and symptoms of cranial nerve compression (optic nerve is most common), and damage to the pituitary gland may cause pituitary dysfunction. Protrusion to the side or downward may form a mass in the nasopharynx, blocking the nasal cavity and causing purulent and bloody secretions. Those occurring at the lower end of the slope and the junction of the skull and neck often present headaches and pain in the occipital region or the occipital-cervical junction as common symptoms. Changes in the position of the head may induce aggravation of the symptoms.

2. If it occurs in the thoracic spine, the tumor can invade the vertebral structure in the corresponding part, protrude into the chest cavity through the intervertebral foramen, and damage the intercostal nerves, which can cause segmental burning neuralgia. It may even cause symptoms of pulmonary pleural irritation. For those occurring in the sacrum and coccyx, the symptoms of sacral tumor compression appear later, and sacral pain is often the main symptom. The typical symptoms are chronic low back and leg pain, which is persistently aggravated at night and has a history of up to 0.5 to 1 year. When the tumor is larger, the mass squeezes the pelvic organs forward and compresses the sacral nerve roots, causing incontinence and difficulty urinating, as well as numbness or pain in the lower limbs and buttocks. The mass can produce mechanical obstruction, causing urinary disorders and constipation. If it occurs in other parts of the spinal canal, local pain in the corresponding area is a common symptom.

3. During clinical examination of sacral canal chordoma, the sacrum can be seen to be full, and the tumor can be felt during rectal examination. It is round, smooth, and has a certain elasticity. Most slowly growing tumor masses expand and grow forward and are difficult to detect clinically. They are only discovered in the late stages when the tumor breaks backward into the gluteal muscles, sacrospinal muscles, or subcutaneous tissue. The mass may also be felt in the lower abdomen. Digital rectal examination is a routine examination for early detection of sacral tumors, especially for patients with chronic lower abdominal pain that has not been cured for a long time. Digital rectal examination is particularly important when sacral tumors are suspected.

4. Pain is the earliest symptom, which is mostly caused by the expansion of the tumor, invasion or compression of adjacent important tissues or organs. Tumors located in the sacrum and coccyx often cause coccygeal pain, followed by the appearance of local lumps, which gradually grow larger and bulge out from under the skin. They may also develop into the pelvic cavity, compressing the bladder and rectum, causing symptoms such as urinary incontinence, constipation, and sciatica. Tumors located in the spheno-occipital region can compress the optic nerve and other cranial nerves, pituitary gland, brain stem, etc., and may cause intracranial hypertension in the later stages. If there is spinal cord compression around the vertebral canal, it may cause radicular pain, paraplegia, incontinence, etc.