• Valerio Pipola, Marco Girolami, Riccardo Ghermandi, Giuseppe Tedesco, Gisberto Evangelisti, and Alessandro Gasbarrini.
• Department of Oncologic and Degenerative Spine Surgery, Rizzoli Orthopedic Institute, Via G.C. Pupilli 1, 40136, Bologna, Italy. valeriopipola@gmail.com.
• Eur Spine J. 2018 Dec 1; 27 (12): 3059-3063.

PurposeChordoma is a low-grade malignant tumor with recurrence and metastasis tendency that originates from embryonic notochordal remnants. The sacrococcygeal region is the most commonly involved site. The aim of this paper is to report the results of the use of cryosurgery in the excision of a giant recurrent sacral chordoma and review of pertinent literature.MethodsA 64 years old female patient with a locally recurrent sacral chordoma came to our attention after ten interventions performed at another institute. A surgical treatment was performed using argon cryosurgery.ResultsIn this case, it was not possible to perform a marginal or wide excision, but it was intralesional with the removal of three major blocks. The fragments sent for the histological analysis measured total 35 × 30 × 8 cm with a weight of 4.260 g.ConclusionsGiven the gelatinous structure of the tumor and the possibility of contamination of operatory field, cryosurgery may be indicated when previous surgeries and the dimensions of tumor mass do not allow a resection with negative margins improving radiotherapy efficacy in the local control of tumor.

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