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                February  2004                                         Case - 4   

                                  Dr  Sampurna Roy  MD    

                                 

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            Clinical History: 

               A 38 year old man presented with a mass at the sacrococcygeal region, present for last 12 years.

               The patient complained of low backache and recent  increase in size of the mass. FNAC was inconclusive.

               Plain radiograph of the pelvis revealed a well delineated radioopaque, oval shaped mass.

               No bony destruction of the sacrum was present.

               MR images showed a well encapsulated mass in the subcutaneous tissue which did not extend into  

               the adjacent structures. There was no evidence of any intraspinal tumour.

               Preoperatively the differential diagnosis included a pilonidal cyst or a sacrococcygeal  teratoma.

               The tumour was surgically excised and submitted for histopathological examination.

               Gross:

           
  The tumour is  firm, ovoid, well encapsulated and multilobulated, 5cm in maximum dimension.

              There are focal areas of haemorrhage.

              Immunohistochemistry:

              GFAP and vimentin -Positive.  Cytokeratin, EMA , chromogranin, carcinoembryonic antigen- Negative.


                                        

                                                                      

                                                            DIAGNOSIS:

 

                                                              


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