Fig. 1

Patient no. 5 suffered from pain in the buttock and gait abnormality for 2 months, X-ray (a), CT (b, c), and MRI (d, e) were performed preoperatively and a large tumor in the sacrum was revealed. A fine needle biopsy confirmed ASPS where surgical resection was indicated. After the tumor resection, screw and rod reconstruction was performed (f). The post operative histological examination (g) and the TFE3 positive immunochemistry (h) confirmed the pathology diagnosis of ASPS. Metastasis was detected 3 months later (i) and two further surgeries were performed. Unfortunately, this patient succumbed to the disease 5 months after the first surgery