{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:34:32Z","timestamp":1770989672712,"version":"3.50.1"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Sacral chordomas are rare malignant bone tumors that are locally aggressive and difficult to treat due to proximity to pelvic viscera, neurovascular structures, and the high risk of surgical morbidity. En bloc resection with negative margins remains the gold standard, but it is often not feasible in large or adherent tumors. Rectal perforation is a rare yet potentially catastrophic intraoperative complication that remains sparsely reported.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n We report the case of a 70-year-old man presenting with progressive back and gluteal pain, urinary difficulty, and bowel dysfunction. Magnetic resonance imaging revealed a giant sacrococcygeal chordoma (16.2 \u00d7 12.2 \u00d7 11.7 cm) compressing the rectum and sacral canal. Pre-operative arterial embolization of the bilateral internal iliac, median sacral, and feeding arteries was performed. During intralesional resection through a posterior approach, a rectal microperforation was detected, prompting intraoperative consultation with the general surgery team. The defect was repaired, and a trephine sigmoid colostomy was created. Tumor debulking was completed with an estimated blood loss of 300 mL. Histopathology confirmed chordoma. The patient recovered well, with a functional stoma and satisfactory wound healing.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Managing giant sacrococcygeal chordomas utilizing the \u201cgold standard,\u201d\n en bloc<\/jats:italic>\n resection, may risk rectal perforation due to visceral adherence. Prompt intraoperative recognition and management of this adverse event are critical, along with a multidisciplinary approach to maximize patient safety.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1358_2025","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:28:50Z","timestamp":1770985730000},"page":"92","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of a large sacrococcygeal chordoma complicated by rectal perforation: A case report"],"prefix":"10.25259","volume":"17","author":[{"given":"Tommy Alfandy","family":"Nazwar","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya \u2013 Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasim","family":"Amar","sequence":"additional","affiliation":[{"name":"Clinical Medical Student, Faculty of Medicine, Universitas Brawijaya - Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhad","family":"Bal\u2019afif","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya \u2013 Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donny Wisnu","family":"Wardhana","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya \u2013 Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fachriy","family":"Bal\u2019afif","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya \u2013 Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christin","family":"Panjaitan","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya \u2013 Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"10.25259\/SNI_1358_2025\/ref-1","first-page":"1","article-title":"Sacral chordoma incidentally discovered in a patient with acute gastrointestinal perforation during his first visit to the 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Biomed"},{"key":"10.25259\/SNI_1358_2025\/ref-5","first-page":"243","article-title":"Surgical management of sacral chordoma","volume":"76","author":"Ozger","year":"2010","journal-title":"Acta Othop Belg"},{"key":"10.25259\/SNI_1358_2025\/ref-6","doi-asserted-by":"crossref","first-page":"2939","DOI":"10.1007\/s11999-010-1472-8","article-title":"Surgical margins and local control in resection of sacral chordomas","volume":"468","author":"Ruggieri","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.25259\/SNI_1358_2025\/ref-7","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1016\/S1470-2045(14)71190-8","article-title":"Building a global consensus approach to chordoma: A position paper from the medical and patient community","volume":"16","author":"Stacchiotti","year":"2015","journal-title":"Lancet Oncol"},{"key":"10.25259\/SNI_1358_2025\/ref-8","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/j.jocn.2009.12.019","article-title":"Pre-operative transarterial embolization for treatment of primary sacral tumors","volume":"17","author":"Yang","year":"2010","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_1358_2025\/ref-9","doi-asserted-by":"crossref","first-page":"412","DOI":"10.4103\/jcvjs.jcvjs_124_21","article-title":"Outcomes of chordomas of the sacrum and mobile spine: Clinical series with average 6-year follow-up","volume":"12","author":"Zileli","year":"2021","journal-title":"J Craniovertebr Junction Spine"},{"key":"10.25259\/SNI_1358_2025\/ref-10","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1177\/21925682211011444","article-title":"Outcomes of surgery for sacral chordoma and impact of complications: A report of 50 consecutive patients with long-term follow-up","volume":"11","author":"Zuckerman","year":"2021","journal-title":"Glob Spine J"}],"container-title":["Surgical Neurology 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