The Value of Preoperative Biopsy in the Management of Solid Presacral Tumors

Merchea, Amit; Larson, David W.; Wenger, Doris E.; Rose, Peter S.; Dozois, Eric J.

doi:10.1097/dcr.0b013e3182788c77

Cited by 52 publications

(50 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The authors have suggested previously that good quality MRI and/or CT images are sufficient to establish the diagnosis and to plan the surgical procedure. Although this view is supported by a number of authors, some have argued that such biopsies compromise safety and risk seeding tumour along the biopsy track; others have argued that a percutaneous preoperative biopsy should be obtained to guide management decisions. Although biopsy is safe if the transrectal approach is avoided, and is concordant with the postoperative pathology findings, it rarely influences management.…”

Section: Discussionmentioning

confidence: 99%

Preoperative assessment of retrorectal tumours

Sagar

Koshy

Hyland

et al. 2014

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Preoperative assessment of retrorectal tumours

Sagar

Koshy

Hyland

et al. 2014

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…On the one hand, given the limitations of imaging to make a definitive diagnosis, percutaneous biopsy of solid or heterogeneous presacral tumors could be obtained preoperatively to facilitate decision making for the use of neoadjuvant therapies and for optimizing surgical planning. 29 On the other hand, there is the fear that it can lead to contamination or tumor spread. Some authors only recommend a biopsy to be performed if the lesion appears to be unresectable and if a tissue diagnosis is required to guide neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Tailgut cyst adenocarcinoma

et al. 2019

View full text Add to dashboard Cite

Tailgut cysts (TGCs) are rare congenital entities arising from remnants of the embryological postanal primitive gut. Malignancy in TGCs is rare, with the majority being adenocarcinomas and carcinoid tumors. A search of the published literature yielded only 27 cases of adenocarcinoma developing in TGCs. We described the case of a 54-year-old female who presented with complaints of pelvic and perineal pain of several weeks. After the initial work-up, a mass in the right presacral location was diagnosed. She underwent radical resection of the tumor, using a posterior approach. The lesion was removed en bloc with the middle rectum, coccyx, and sacrum (S4-S5). The histopathologic examination revealed an adenocarcinoma arising in a TGC, and the patient received adjuvant chemoradiotherapy. Our case underlines that diagnosing a TGC is difficult as it is a rare congenital lesion. Clinical examination may be challenging as TGCs present with various symptoms, which can mimic other commonly proctologic disorders. Patients should be referred to a tertiary center with experience in pelvic surgery and must be managed by a multidisciplinary approach to maximize successful treatment. The recommended treatment is surgical excision given the malignant potential of TGCs and their risk of causing local complications.

show abstract

“…It has also been argued that MRI is sufficient to allow surgical planning and prediction of potential complications [2,16], and a recent study found that the results of preoperative biopsy did not influence management [13]. A recent study by Merchea et al [15], however, has shown that preoperative biopsy is safe and allows optimal management of the tumour. They reported a specificity of 100% in differentiating between benign and malignant disease on preoperative biopsy with a sensitivity of 96% compared with a specificity and sensitivity of 81% and 83% for imaging alone.…”

Section: Discussionmentioning

confidence: 99%