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. 2011 Sep;24(3):149-60.
doi: 10.1055/s-0031-1285999.

Retrorectal tumors

Jeffrey A Neale

Retrorectal tumors

Jeffrey A Neale. Clin Colon Rectal Surg. 2011 Sep.

Abstract

Tumors that arise in the retrorectal (presacral) space are uncommon lesions that present with nonspecific signs and symptoms, which lead to difficult diagnoses. For complete evaluation of the lesion, cross-sectional imaging is required to determine the extent of resection and the 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, are essential to determine the necessity of neoadjuvant therapy, which may decrease local recurrence after surgery and avoid an unnecessary delay in systemic therapy.

Keywords: Retrorectal tumors; outcomes; presacral; prognosis; treatment.

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Figures

Figure 1
Figure 1
(A) Anterior and (B) posterior view of pelvic anatomy. From Dozois et al. Reprinted with permission of the American Society of Colon and Rectal Surgery.
Figure 2
Figure 2
“Scimitar sign”: Pathognomonic for anterior meningocele. Reprinted from Bou-Assaly W, Ilner A, Delaney L, Gunderman R. AJR teaching file: child with chronic constipation. Am J Roentgenol 2007;189(3 Suppl): S29–S31, with permission of the American Roentgen Ray Society.
Figure 3
Figure 3
Proposed surgical approach based on tumor level. From Dozois et al. Reprinted with permission of the American Society of Colon and Rectal Surgery.
Figure 4
Figure 4
Combined approach (abdominoperineal). (A) Modified lateral position (sloppy lateral position), (B) exposure of pelvic structures and tumor, and (C) exposure of sacrum. From Dozois et al. Reprinted with permission of the American Society of Colon and Rectal Surgery.
Figure 5
Figure 5
(A) Exposure of sciatic nerves, (B) exposure of sacral nerve roots, and (C) exposure of thecal sac. From Dozois et al. Reprinted with permission of the American Society of Colon and Rectal Surgery.
Figure 6
Figure 6
Posterior approach. (A) Positioning, (B) coccygectomy, and (C) the index finger applying pressure within the anal canal, exposing the lesion and facilitating dissection. From Dozois et al. Reprinted with permission of the American Society of Colon and Rectal Surgery.
See this image and copyright information in PMC

References

    1. Hobson K G, Ghaemmaghami V, Roe J P, Goodnight J E, Khatri V P. Tumors of the retrorectal space. Dis Colon Rectum. 2005;48(10):1964–1974. - PubMed
    1. Johnson W R. Postrectal neoplasms and cysts. Aust N Z J Surg. 1980;50(2):163–166. - PubMed
    1. Cody H S, III, Marcove R C, Quan S H. Malignant retrorectal tumors: 28 years' experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum. 1981;24(7):501–506. - PubMed
    1. Uhlig B E, Johnson R L. Presacral tumors and cysts in adults. Dis Colon Rectum. 1975;18(7):581–589. - PubMed
    1. Jao S W, Beart R W, Jr, Spencer R J, Reiman H M, Ilstrup D M. Retrorectal tumors. Mayo Clinic experience, 1960-1979. Dis Colon Rectum. 1985;28(9):644–652. - PubMed