Imaging of Unusual Perineal Masses

Abstract

The perineal space is often overlooked because of the infrequency of abnormalities. Accurate image interpretation and visualization of extent of pathology is important for proper management. Trauma and infectious diseases occur in the acute setting, whereas tumors are common in the chronic setting. Cross-sectional imaging plays a crucial role in depicting perineal anatomy and evaluating the extent of disease.

MRI and CT of anal carcinoma: a pictorial review

“…Furthermore, cross-sectional imaging particularly with MRI also proves useful to differentiate anal carcinoma from other causes of local pain and perineal masses, such as pilonidal sinus diseases, Gartner duct or Bartolini gland cysts, tailgut cysts, uncommon soft-tissue neoplasms, urethral cancer, lymphoma or metastases [14, 22]. …”

Use of MRI to identify enlarged inferior gluteal and ischioanal lymph nodes and associated findings related to the primary disease

“…The nodes in the ischioanal fossa are at risk for harboring metastases from the cancers of the distal rectum, anal canal, Bartholin's glands, prostate, and urinary bladder. Lymphoma can also cause the lymph nodes to become enlarged in the ischioanal space (3)(4)(5)(6)(15)(16)(17)(18).…”

Giant Perineal Leiomyoma: A Case Report and Review of the Literature

“…However, perineal leiomyomas can have variable MRI presentations [1, 7] (Table 3). It is important to consider a gastrointestinal stromal tumor (GIST) as a differential and distinguish it from a leiomyosarcoma [1].…”

“…Rectal GIST typically are heterogeneously enhancing exophytic masses that can sometimes present with hemorrhage and although the radiologic features of GIST are often distinct from those of epithelial tumors, criteria to separate GIST radiologically from other nonepithelial tumors have not yet been fully developed [7]. …”

“…The aim of surgery is to obtain negative margins of resection preserving function [7]. The local recurrence after resection of perineal leiomyomas is rare.…”