摘要
脊索瘤(chordoma)是一種生長緩慢但會產生局部侵襲性的腫瘤。脊索瘤起源於脊索的遺跡，脊索是胚胎中的中胚層結構，後來退化成為椎間盤中的髓核(nucleus pulposus)。脊索瘤最常發生在骶骨，顱底次之，評估以影像和病理切片為主；素片(plain film)可顯示局部破壞性裂解病變，電腦斷層(CT)掃描和磁振造影(MRI)可以最佳描繪脊索瘤的範圍。本次報告為一名67歲女性病患，右側臀部有一大於10公分腫塊，有腰部以下疼痛，便秘及漏尿之情形至本院求診，安排病患做plain film、CT、MRI檢查，在影像上發現骶骨被破壞，兩側骨盆有巨大葉腫塊(lobulated mass)，腫塊不止分布於骶骨前，也侵犯到骶骨後和兩側臀部和脊椎硬膜外腔，最終病理切片(pathology biopsy)後證實為脊索瘤。
並列摘要
Chordomas are slow growing but locally invasive tumors. Chordomas arise from remnants the notochord that becomes the nucleus pulposus as it regresses. The most common involving site of chordomas is the sacro-coccygeal region and the skull base is the second common site. Evaluation of chordomas depends on imaging studies and biopsy. Plain films may show bony destruction. The tumor extention and involvement clearly demonstrate on CT and MRI studies. Our case was a 67 y/o female presented to OPD of our hospital due to more than 10cm right gluteal mass lesion. Lower back pain, constipation and urinary incontinence were also complained. Lumbar-sacral spine AP, Lat view, CT and MRI were arranged and showed sacral bone destruction and bilateral pelvic cavity lobulated masses. The tumor masses were not only in pre-sacral region but also extended to post-sacral region, bilateral gluteal region and LS spine epidural region. Biopsy was performed later and pathology confirmed chordoma.