Retrorectal tumors

Abstract

Tumors that arise in the retrorectal, (presacral), space are uncommon lesions. Diagnosis and management remain difficult. These tumors present with nonspecific signs and symptoms thereby leading to a difficulty in diagnoses. For complete evaluation of the lesion cross sectional imaging, most importantly MRI is required, for diagnostic purposes, and can determine between benign and malignant lesions, as well as the extent of resection. MRI is also utilized to determine the most appropriate surgical approach. Surgical removal leads to favorable outcomes for patients with benign purely cystic retrorectal tumors. Preoperative tissue diagnosis with transperineal and transsacral biopsies of solid or heterogeneous cystic lesions, plays a role in determining the necessity of neoadjuvant therapy which may decrease local recurrence after surgery and avoid an unnecessary delay in systemic therapy. However, if one is to perform a biopsy one must abides by certain principles during the biopsy.

Case report: Laparoscopic approach in the treatment of presacral lipoma

“… Highlights Retrorectal lipoma is a benign mesenchymal tumour composed of mature adipose tissue, located in the retrorectal space [ 1 ]. Retrorectal tumours in adults are rare [ [3] , [4] , [5] , [6] , [7] , [8] , [9] ], Jao et al found that retrorectal tumours accounted for 1 in 40,000 hospital admissions [ 5 ]. Miscellaneous, non classified tumours account for 10–25% of all retrorectal tumors.…”

“… Miscellaneous, non classified tumours account for 10–25% of all retrorectal tumors. Retrorectal lipomas are included in this group [ 4 , 7 ]. These tumours usually affect middle-aged patients and occurs twice as often in women as in men [ 7 ].…”

“… These tumours usually affect middle-aged patients and occurs twice as often in women as in men [ 7 ]. Retrorectal lipomas, as well as other benign retrorectal tumours, are often completely asymptomatic [ 4 , 6 , 8 , 9 ]. They are usually found incidentally when performing a pelvic or rectal examination [ 4 , 9 ].…”

“… Retrorectal lipomas, as well as other benign retrorectal tumours, are often completely asymptomatic [ 4 , 6 , 8 , 9 ]. They are usually found incidentally when performing a pelvic or rectal examination [ 4 , 9 ]. Retrorectal lipomas also might give nonspecific symptoms, mostly from the compression of pelvic structures, viscera and nerves.…”

“…Currently, computed tomography scan used in conjunction with magnetic resonance imaging scan is the gold standard in diagnosing retrorectal tumours [ 4 ]. These methods are used to find out the size, structure of the tumour, its relationship with surrounding organs that is a necessary information for planning surgical approach [ 3 , 4 , 8 ]. Biopsy should not be performed before a surgery [ 5 , 6 ].…”