A 62-year-old man presented with gluteal and bilateral lower limb swelling. He had a history of acute retention of urine 2 years previously but no other complaints. A pelvic radiograph (Fig. 1a) shows extensive midline bony destruction of the sacrum with a soft tissue mass between the arrowheads. A CT of the abdomen and pelvis (Fig. 1b) shows a large destructive soft tissue mass centred at the sacrum (*), extending into the pelvis and posterior subcutaneous regions with internal calcifications (dashed circle). An axial T2-weighted MRI (Fig. 1c) shows a lobulated hyperintense mass arising from the sacrum (*) with extension into the bilateral gluteal regions (arrowheads) and pelvis with anterior deviation and mass effect on both the rectum (arrow) and urinary bladder (dashed arrow). These imaging features were compatible with a sacral chordoma and this was confirmed on histopathology.