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. 2009 May;22(2):84-93.
doi: 10.1055/s-0029-1223839.

Presacral tumors: diagnosis and management

Imran Hassan  1 , E Dawn Wietfeldt
Affiliations

Presacral tumors: diagnosis and management

Imran Hassan et al. Clin Colon Rectal Surg. 2009 May.

Abstract

Presacral tumors are uncommon lesions that can be difficult to diagnose because of their nonspecific presenting signs and symptoms. Cross-sectional imaging is essential in evaluating these lesions to determine the optimal surgical approach and the extent of resection. Surgery is the mainstay of treatment as it establishes the diagnosis and prevents the adverse consequences associated with malignant degeneration and secondary bacterial infection. The outcomes for patients with benign presacral tumors are favorable. Although there have been substantial improvements in the prognosis of patients with malignant presacral tumors, the development of newer adjuvant therapies are likely to further improve the oncologic outcomes of malignant presacral tumors such as chordomas and sarcomas.

Keywords: Presacral tumors; diagnosis; management; prognosis; surgery.

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Figures

Figure 1
Figure 1
Relationship of pelvic structures to the presacral space. From Mayo Clinic, Rochester, NY. Reproduced with kind permission of Springer Science and Business Media.
Figure 2
Figure 2
Management flowchart for presacral tumors.
Figure 3
Figure 3
Relationship of tumor to sacral level and proposed approach. From Mayo Clinic, Rochester, NY. Reproduced with kind permission of Springer Science and Business Media.
Figure 4
Figure 4
(A) Positioning for posterior approach. (B) Coccygectomy. (C) Index finger in anal canal to push tumor outward to facilitate dissection. From Mayo Clinic, Rochester, NY. Reproduced with kind permission of Springer Science and Business Media.
See this image and copyright information in PMC

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