The case of a 49-year-old male could be assessed after his condition is thoroughly described. Hodgkin’s lymphoma is a kind of carcinoma that damages the lymph nodes, which is a component of the body’s immune. Lymphocytes proliferate uncontrollably in Hodgkin’s lymphoma, generating swelling lymph vessels and outgrowths across the organs of the body (Mayo Clinic, 2022). The tumor has spread downwardly on the right anterior sacral foramina, which presents holes in the sacrum’s (a bone under the lumbar vertebrae) concave anterior area. Sacral nerves’ anterior branches and the lateral sacral arteries travel through the right anterior sacral foramina. Moreover, the mass has extended across the right body of the ischium, which is a section of the hip bone. As a result, the greater sciatic foramen that opens the posterior pelvis is closed by this mass.
There are several functional complications that will persist with the above criteria and scenario. As such, lymphocytes begin to multiply excessively and grow very quickly in large groups in certain regions of the lymph nodes. The damaged lymphocytes lose their ability to fight infection, making a person more susceptible to disease (NHS, 2021). It implies that the patient has a compromised immune system, and he is more likely to be infected and, moreover, is more likely to suffer significant consequences from diseases.
The tumor in the right anterior sacral foramina is also malignant and could also be called chordoma. The sacrum is a strong bone that can withstand massive strain and movement. It acts as a base that connects the spinal cord to the pelvis. For humans to sit erect, the sacrum creates a stable platform; however, the tumor disrupts this function, causing difficulties in walking and sitting (Verywell Health, 2020). Thus, the sacrum serves as an attachment point for the spinal column to link to the pelvis, maintaining stability for the base of the spine, which is work is compromised in the case of a tumor in the right anterior sacral foramina.
Another issue that arises because of the patient’s problem is connected to the mass concentrated in the ischium. The ischium is a lean mass bone in the body that constructs the posterior inferior portion of the pelvis. The ischium’s core is connected with the ilium and pelvic bones, including the dorsal surface (Saad et al., 2019). According to Saad et al. (2019), “the posterior aspect of the dorsal surface is important in separating this area into the lesser and greater sciatic notches, … converted into foramina” (p. 17). These two components are critical for gaining access to key nerves, arteries, and muscles (Saad et al., 2019). As was revealed by clinical observation, the greater sciatic foramen is closed due to the tumor spreading into the ischium. Hence, some vessels, nerves, and muscles cannot interact with the rest of the body. This complication creates significant problems for moving and general coordination of the person.
As was previously mentioned, the affected blood vessels include lymphocytes; more precisely, B-lymphocytes are under threat. Moreover, the nerves that are damaged by the disease include the anterior divisions of the sacral nerves, as well as the lateral sacral arteries, as was described earlier. As for the muscles, the iliacus muscle around the pelvis are to be disrupted because of ischium’s mass. The anatomical structures that change under this condition are pelvis, right anterior sacral foramina, ischium, and greater sciatic foramen.
Finally, this condition causes a specific pain distribution in the individual. As such, the sacrum is frequently mentioned as a source of lower back discomfort (Verywell Health, 2020). The research from Pillai and Govender (2018) confirms that constant lower backache, which is worse when seated, is the most prevalent presenting characteristic in individuals with sacral chordoma. Finally, the issues of the immune system associated with the compromised work of the lymph nodes indicate that the pain from the infection is also present and might be more severe in people with the mentioned type of cancer.
References
Mayo Clinic. (2022). Hodgkin’s lymphoma (hodgkin’s disease). Web.
NHS. (2021). Hodgkin lymphoma. Web.
Pillai, S., & Govender, S. (2018). Sacral chordoma : A review of literature. Journal of Orthopaedics, 15(2), 679–684. Web.
Saad, A., Kalia, S., le Nail, L. R., Davies, M., James, S., & Botchu, R. (2019). Isolated ischial lesions – demographics and imaging features. Indian Journal of Musculoskeletal Radiology, 1, 14–20. Web.
Verywell Health. (2020). The anatomy of the sacrum. Web.