Sacral tumors can be metastases or primary tumors. The latter represent an uncommon entity, only accounting for approximately 7% of all primary tumors of the spine. While giant cell tumors and chordomas are the most frequent tumor type, they are also considerably resistant to chemo- and radiotherapy . Along with their slow speed of growth sacral tumors most commonly induce only minor symptoms resulting in large tumors when the patients present in our clinics . Moreover, many sacral tumors, such as chordomas and chondrosarcomas are proved to have a better oncological outcome if resected en bloc; yet, this is not possible in a large protion of cases . This, however, is surgically demanding considering the critical biomechanical role, complex anatomy, interdisciplinary involvement, and frequently large anterior tumor mass.
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