56-year-old female patient suffered from a lumbago for one year with a severe constipation. All lab data were in normal limits. X-rays showed an osteolysis of sacrum bone from S3 to S5. There was a presacral solid hypoechoic mass in 57 x 48 mm (length x width), lobulated, with some calcifications on a transabdominal ultrasound scanning using the 3.5MHz convex probe. The 7.5MHz linear probe from the back of the lumbar region presented a solid mass #72x42mm (lenghth x thickness), with sacral osteolysis.
MRI revealed a lesion from S3 with the dimensions of 50 x 65 x 70mm (anteroposterior x superoinferior x width), demarcated well-limited, lobulated, having low signals on T1WI and high signals on T2WI, highly taken the contrast media.
The anatopathologic result was a sacrococcygeal chordoma after a subtotal removal of this mass and a process of radiotherapy was done.
Althought there are some other sophisticated modalities of diagnostic imaging, ultrasound with experiences could diagnose a chordoma in sacral region.
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