Is There Another Posterior Approach for Presacral Tumors Besides the Kraske Procedure? — A Study on the Feasibility and Safety of Surgical Resection of Primary Presacral Tumors via Transsacrococcygeal Transverse Incision

Zhao, Xudong; Zhou, Sheng; Liu, Na; Li, Peiyu; Chen, Lin

doi:10.3389/fonc.2022.892027

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…The exact etiology of MERS is unknown, although infections and antiepileptic drugs have been implicated, with no known association with tumors. Adult sacrococcygeal tumors are diverse, including benign tumors like epidermoid cysts (33.6%) and mature teratomas (25.5%), as well as malignant tumors such as teratomas with malignant transformation (2.7%) and fibromyxoid sarcoma (1.8%) [3]. Preoperative diagnosis is difficult due to the risk of seeding from biopsy.…”

Section: Introductionmentioning

confidence: 99%

Coexisting Sacrococcygeal Teratoma With Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion: A Case Report

Fujimoto,

Deguchi,

Shirai

et al. 2024

Cureus

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Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a rare disease characterized by a reversible lesion in the splenium of the corpus callosum (SCC) observed on MRI. The exact etiology of MERS is unknown, although infections and antiepileptic drugs have been reported as potential causes. Herein, we present the case of a 56-year-old male patient who experienced fever and headache for 3 days. He was referred to our hospital after symptomatic treatment by his primary care physician failed to improve his symptoms. The patient had no psychiatric symptoms or significant neurological findings. Head MRI revealed a high signal on SCC on diffusion-weighted imaging, raising the suspicion of MERS. All examinations to determine the cause of MERS were negative. The patient's symptoms improved with antibiotics and B complex vitamins. Upon admission, abdominal CT incidentally revealed a well-defined mass on the dorsal surface of the rectum suspected to be a tailgut cyst, warranting surgical resection. The cranial margin of the tumor was caudal to the third sacrum, and a trans-sacral approach was used for resection. The fifth sacrum and the coccyx were resected, and the tumor was resected without damaging the rectum. A histopathological examination revealed a mature teratoma without any malignancy. A follow-up CT at four months postoperatively showed no evidence of clinical recurrence of MERS. Adult-onset MERS is relatively rare, and no association with tumors has been reported. The association between encephalitis and teratomas includes ovarian teratomas, which cause anti-N-methyl-D-aspartate receptor encephalitis and paraneoplastic limbic encephalitis. Although the cause of MERS was unknown in this case, we report the coexistence of a sacral teratoma and MERS to contribute to the knowledge of the association between them.

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Section: Introductionmentioning

confidence: 99%

Coexisting Sacrococcygeal Teratoma With Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion: A Case Report

Fujimoto,

Deguchi,

Shirai

et al. 2024

Cureus

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The management of retrorectal tumors – a single-center analysis of 21 cases and overview of the literature

Fechner,

Bittorf,

Langheinrich

et al. 2024

Langenbecks Arch Surg

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Aim Retrorectal tumors are rare and heterogeneous. They are often asymptomatic or present with nonspecific symptoms, making management challenging. This study examines the diagnosis and treatment of retrorectal tumors. Methods Between 2002 and 2022, 21 patients with retrorectal tumors were treated in our department. We analyzed patient characteristics, diagnosis and treatment modalities retrospectively. Additionally, a literature review (2002–2023, “retrorectal tumors” and “presacral tumors”, 20 or more cases included) was performed. Results Of the 21 patients (median age 54 years, 62% female), 17 patients (81%) suffered from benign lesions and 4 (19%) from malignant lesions. Symptoms were mostly nonspecific, with pain being the most common (11/21 (52%)). Diagnosis was incidental in eight cases. Magnetic resonance imaging was performed in 20 (95%) and biopsy was obtained in 10 (48%). Twenty patients underwent surgery, mostly via a posterior approach (14/20 (70%)). At a mean follow-up of 42 months (median 10 months, range 1–166 months), the local recurrence rate was 19%. There was no mortality. Our Pubmed search identified 39 publications. Conclusion Our data confirms the significant heterogeneity of retrorectal tumors, which poses a challenge to management, especially considering the often nonspecific symptoms. Regarding diagnosis and treatment, our data highlights the importance of MRI and surgical resection. In particular a malignancy rate of almost 20% warrants a surgical resection in case of the findings of a retrorectal tumour. A local recurrence rate of 19% supports the need for follow up.

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Pre-sacral glomangioma: a rare localization of glomus tumors: case report

Mseddi,

Siala,

Yaakoubi

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction and importance: Deep located glomangiomas are rarely reported. Because of their scarcity, treatment strategie is hard to establish. Herein, we report the first case to our knowledge of presacral glomangioma. Case presentation: A 34-year-old female patient, with no previous medical history, consulted for 2-month-old pelvic abdominal pain, vomiting and delayed menstruation. Her physical and biological parameters were with no abnormalities. MRI of the pelvis demonstrated a 14 cm mixed heterogeneous pre-sacral lesion pushing the rectum anteriorly. She was operated on via a laparoscopic approach. Division of Douglas’ pouch and pelvic peritoneum laterally to the bladder showcased a cystic lesion of 13×8 cm occupying the pelvis while deviating the rectum anteriorly. Its content was aspirated and left membrane was extracted in a sac. The postoperative course was uneventful. Discussion: Presacral masses are hard to treat because of their large heterogeneity. Surgical resection should be tempted to retrieve the definitive histological diagnosis and relieve the patient. However, the surgical route is controversial as each approach has its advantages. Thus, the surgical route should take into consideration the lesion’s size, height and surrounding contacts, the patient’s functional state and surgeon’s expertise. Conclusion: Presacral glomangiomas carries low malignant pattern but should be resected to offer histological diagnosis. The surgical route remains at the surgeon’s decision, with the main objective to totally resect the encountered lesion without causing functional and sexual complications or harm to surrounding viscera.

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Is There Another Posterior Approach for Presacral Tumors Besides the Kraske Procedure? — A Study on the Feasibility and Safety of Surgical Resection of Primary Presacral Tumors via Transsacrococcygeal Transverse Incision

Cited by 4 publications

References 33 publications

Coexisting Sacrococcygeal Teratoma With Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion: A Case Report

Coexisting Sacrococcygeal Teratoma With Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion: A Case Report

The management of retrorectal tumors – a single-center analysis of 21 cases and overview of the literature

Pre-sacral glomangioma: a rare localization of glomus tumors: case report

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