Figure 1. Imaging studies obtained in a patient with sacral GCT. Upper Left: Anteroposterior radiograph of the pelvis and sacrum. Upper Right: Lateral radiograph of the sacrum. Although a destructive mass can be identified in the sacrum, its extent is poorly demarcated. Center Left and Right: Axial CT scans demonstrating the cephalad extent (center left) and caudad extent (center right) of the disease. Lower Left and Right: Sagittal (lower left) and coronal (lower right) magnetic resonance images revealing the anterior soft-tissue extension.

Figure 2. Photomicrograph showing a tissue specimen of sacral GCT. Note the omnipresent multinucleated giant cells and the absence of mitotic activity. H&E, original magnification × 10.

Figure 3. Axial CT scan of the chest obtained in a patient with advanced metastatic involvement of the lung. Note the bilateral malignant pleural effusions. The patient soon died after this scan was acquired.

Figure 4. Partial sacrectomy at S-3. Upper: Intraoperative photograph. The bilateral S-2 nerve roots were spared, and the patient experienced minimal bowel and bladder dysfunction. Center: Intraoperative photograph showing a rectal patch in place to prevent rectal prolapse. Lower: Postoperative radiograph demonstrating the preservation of S-1 and S-2 segments.

Figure 5. Preoperative angiograms demonstrating embolization of sacral GCT. Left: Tumor blush prior to embolization. Right: After embolization, flow is diminished but still present.

Figure 6. Anteroposterior radiograph revealing reconstruction of region after total sacrectomy.