Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 23534
  Title A 69-year-old presenting with musculoskeletal low back pain: A case of lumbosacral chordoma [case report]
URL http://dx.doi.org/10.1016/j.jcm.2014.06.007
Journal J Chiropr Med. 2014 Jun;13(2):144-148
Author(s)
Subject(s)
Peer Review Yes
Publication Type Case Report
Abstract/Notes

Objective: The purpose of this case report is to describe the presentation of a patient with lumbosacral chordoma characterized by somatic chronic low back pain and intermittent sacral nerve impingement.

Case report: A 69-year-old male presenting to an emergency department (ED) with low back pain was provided analgesics and muscle relaxants then referred for a series of chiropractic treatments. Chiropractic treatment included manipulation, physical therapy, and rehabilitation. After 3 times per week for a total of 4 weeks, re-examination showed little relief of his symptoms. His pain symptoms worsened and he presented to the ED for the second time. Magnetic resonance imaging was performed and revealed a high intensity mass.

Intervention and outcome: The soft tissue mass identified on magnetic resonance imaging was surgically removed. Shortly after the surgery, the patient developed post-operative bleeding and was returned to surgery. During the second procedure, he developed a post-operative hemorrhage related to the development of disseminated intravascular coagulation and subsequently died during the second procedure. A malignant lumbosacral chordoma was diagnosed on pathologic examination.

Conclusion: This case report describes the presentation of a patient with lumbosacral chordoma presenting with musculoskeletal low back pain. Chordomas are rare with few prominent manifestations. An early diagnosis can potentially make a difference in morbidity and mortality. Due to its insidious nature, it is a difficult diagnosis and one that is often delayed.

This abstract is reproduced with the permission of the publisher; full text is available by subscription.


 

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