Sacrum tumors are abnormal cellular growths that occur in the sacrum. The sacrum is a triangular bone located at the bottom of the spine and connected to the pelvis. Tumors that develop in the sacrum can be benign (benign) or malignant (malignant). They can originate from various types of tissue, such as bone tissue, cartilage, nerve tissue or other structures within the spine.
Some tumors of the sacrum can cause pain, neurological deficits (loss of nerve function) and structural instability of the spine. Particularly large tumors or malignant tumors can put pressure on surrounding tissues, leading to gait disturbances, movement restrictions and even loss of bowel or bladder control. A thorough medical evaluation is necessary to accurately diagnose and effectively treat tumors of the sacrum.
Why do sacrum tumors occur?
The causes of sacrum tumors are quite diverse and can be divided into the following categories:
Primary Tumors
Primary tumors are tumors that develop directly in the sacrum. These tumors can be benign (benign) or malignant (malignant):
- Benign tumors: Benign tumors of the sacrum include osteomas, osteoid osteomas, osteoblastomas and aneurysmal bone cysts. These tumors usually grow slowly and cause less damage to surrounding tissues.
- Malignant Tumors: Malignant tumors include osteosarcoma, chondrosarcoma and Ewing sarcoma. These tumors are usually aggressive and can spread rapidly to surrounding tissues.
Metastatic tumors
Metastatic tumors occur when cancers in other parts of the body spread to the sacrum or lumbar spine. They can spread from various parts of the body, such as breast, prostate, lung and kidney cancers. These tumors are usually malignant and treatment can be more complicated.
Hematologic Malignancies
Tumors originating from blood-forming tissues can also affect the sacrum. Hematologic malignancies such as multiple myeloma and lymphoma can cause problems in the sacrum and lumbar spine.
Genetic Factors
Some sacrum tumors are associated with genetic syndromes. Genetic conditions such as neurofibromatosis and multiple endocrine neoplasia can increase the risk of developing spinal tumors.
Understanding these causes plays an important role in the diagnosis and treatment of sacrum tumors. Early diagnosis and appropriate treatment can positively affect the course of the disease.
Sacrum Tumor Symptoms
Symptoms of lumbar sacrum tumors can vary depending on the type, size and location of the tumor, but common symptoms include
- Localized pain in the lower back or sacral area,
- Pain radiating to the legs, hips or buttocks,
- Numbness, tingling or weakness in the lower limbs,
- Difficulty walking or changes in gait,
- In severe cases, loss of bowel or bladder control,
- Visible swelling or deformity of the lower back.
How is a sacrum tumor diagnosed?
Accurate diagnosis of sacrum tumors requires a combination of a thorough clinical evaluation and various imaging techniques. The main methods used in the diagnosis of sacrum tumors:
X-ray: X-rays are used as a first step to detect bone abnormalities or fractures in the sacrum. This imaging technique can show changes in bone structure and the presence of potential tumors.
Magnetic Resonance Imaging (MRI): Magnetic Resonance Imaging (MRI) provides detailed, high-resolution images of the spinal cord, nerves and soft tissues. MRI is a critical imaging tool for assessing the extent and size of sacrum tumors and their impact on adjacent structures.
Computed Tomography (CT) Scan: A Computed Tomography (CT) scan clearly shows details in the bone structure and possible tumor locations. In addition, CT scans help guide biopsy procedures and analyze the structural features of the tumor.
Bone Scans: Bone scans are used to detect areas of increased bone metabolism that may be indicative of tumors. This method is particularly important in assessing the spread of metastatic tumors and their effects within the bone.
Biopsy A biopsy involves taking a tissue sample to determine the type and malignancy of tumors in the sacrum. A biopsy is a critical step in making a definitive diagnosis of the tumor and determining appropriate treatment methods.
Diagnosis of sacrum tumors involves a combination of various tests and evaluations by specialist physicians. This process is very important for the patient to receive an accurate and effective treatment plan.
Conservative Treatment Methods
For benign tumors or when surgery is not immediately necessary, conservative treatments may be considered, including
Monitoring: Monitoring with regular imaging studies to track tumor growth.
Medications (Painkillers): NSAIDs, acetaminophen or stronger analgesics for pain management.
Bisphosphonates: To strengthen bones and reduce pain in bone metastases.
Physical Therapy: Exercises to maintain mobility and strength and manage pain.
Surgical Treatment Methods
Surgical intervention is usually necessary for symptomatic tumors, those causing neurological deficits or those with suspected malignancy. Surgical options include the following:
Tumor Resection: Complete or partial removal of the tumor. The extent of resection depends on the size and location of the tumor and its relationship to surrounding structures.
Spine Stabilization: In cases where tumor resection has compromised spinal stability, the spine can be stabilized using instrumentation (such as rods, screws and plates).
Decompression Surgery: To relieve pressure on the spinal cord or nerves caused by the tumor.
Minimally Invasive Surgery: Endoscopic or microscopic surgical techniques can shorten recovery times and reduce pain after surgery.
Adjuvant Treatments
Surgical intervention is usually the main approach in the treatment of sacrum tumors. However, especially for malignant tumors, additional adjuvant therapies may be used in addition to surgery. Adjuvant therapies support the complete removal of the tumor and improve the patient's overall recovery by reducing the risk of recurrence. Common adjuvant treatment options for sacrum tumors:
Radiation Therapy: To kill remaining cancer cells after surgery or to shrink tumors before surgery.
Chemotherapy: Systemic treatment for cancers that respond to chemotherapeutic agents.
Targeted Therapy: Drugs that specifically target cancer cells with minimal damage to normal cells.
Immunotherapy: Boosts the body's immune system to fight cancer.
Postoperative Care
Post-operative care for patients with sacrum tumors usually includes
Rehabilitation: Physical therapy to restore strength, mobility and function.
Pain Management: Medications and techniques to manage pain after surgery.
Regular Follow-up: Imaging studies and clinical evaluations to monitor for tumor recurrence or complications.
Tumors of the sacrum are a complex challenge with the potential to cause significant pain, neurological deficits and structural instability of the spine. Understanding the pathology, etiology and available treatment options is critical for effective management. While conservative treatments may be appropriate for benign tumors, surgical intervention is often necessary for symptomatic or malignant tumors. To achieve the best outcomes for patients with tumors of the lumbar sacrum, a multidisciplinary approach should include surgery, radiation, chemotherapy and rehabilitation.
