Chondrosarcoma of sacrum presenting with a deep vein thrombosis

Chondrosarcoma is the second most common primary malignant bone tumor [1]. It is often observed in the pelvis, femur, shoulder girdle and diaphysial portions of long bones [2]. Its incidence in the sacral lesion is very low, and it was reported that only 18 cases of chondrosarcoma were observed out of 900 tumor cases (0.2%) [3]. On the other hand, Ozdemir et al. [4] report that the frequent symptoms and signs of sacral malignant bone tumors including primary and metastatic malignant bone tumors are nonspecific low back pain, sensation of pelvic pressure or discomfort, and neurological symptoms when the tumor compresses the neural structures. Symptoms of deep vein thrombosis (DVT) due to a sacral tumor were not described in this series. Only two cases of a bone tumor initially presenting as DVT have been reported in the English literature. Tasci et al. [5] report a case of Ewing sarcoma of the fibula with venous thrombosis in the popliteal vein, and Hoekstra et al. [6] present a case of pelvic girdle chondrosarcoma with venous thrombosis in the iliac vein and inferior vena cava. However, to our knowledge, a case in which the initial symptom of sacral chondrosarcoma is DVT due to tumor embolism in the iliac vein has not been reported. In this report, we present a case of chondrosarcoma of the sacrum that initially presents as DVT, and discuss the mechanism of this phenomenon.