Needle tract recurrence following radiofrequency ablation of sacrococcygeal chordoma

Chordomas arise in notochord remnants and present most commonly in the sacrococcygeal region. Conventional treatment is with surgery, but due to the infiltrative nature of the tumour there is a high recurrence rate. These recurrences are frequently in adjacent soft tissues or around remaining nerves. Often multiple surgical procedures are required over a prolonged time period, which has a significant impact on the patients’ quality of life. Radiofrequency ablation is now the treatment modality of choice for some intraosseus tumours, such as osteoid osteoma. Its role in the treatment of soft tissue tumours is continuing to expand for both benign and malignant lesions. We describe a case of recurrent sacral chordoma where local control was obtained following radiofrequency ablation, but where tumour recurrence occurred along the needle tract. We look into this modality specific complication and highlight possible ways of reducing its occurrence.