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Case Reports
. 2014 Jan 10;2014(1):rjt120.
doi: 10.1093/jscr/rjt120.

Complexities of abdominoperineal surgery: synchronous resection of an ano-rectal adenocarcinoma and pelvic schwannoma

Ryan P C Higgin  1 , Michael A Glaysher  2 , Bashir A Zeidan  3 , Andrew J G Miles  2
Affiliations
Case Reports

Complexities of abdominoperineal surgery: synchronous resection of an ano-rectal adenocarcinoma and pelvic schwannoma

Ryan P C Higgin et al. J Surg Case Rep. .

Abstract

Abdominoperineal resection (APR) is indicated for low rectal/ano-rectal cancers. It necessitates fastidious pelvic dissection posing certain operative difficulties. We present the surgical challenges in a unique case of a patient presenting with a low rectal adenocarcinoma and a synchronous pelvic schwannomas, both requiring resection. A 71-year-old gentleman presented for surveillance colonoscopy following previous excision of colonic polyps. This investigation revealed a polypoid mass at the ano-rectal junction which was histologically proven as an adenocarcinoma with high-grade dysplasia. A staging computed tomography scan revealed an incidental 10 × 15 cm homogeneous, pre-sacral mass. After meticulous operative planning, the patient underwent successful open resection of this mass and concurrent APR for his low rectal lesion. This case demonstrates a rare presentation of a low rectal adenocarcinoma and concurrent pelvic schwannoma. We discuss the technical difficulties encountered in the management of such complex pelvic tumours and highlight the successful outcomes of the synchronous resection.

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Figures

Figure 1:
Figure 1:
A colonoscopic image demonstrating ∼1-cm polypoid mass at the ano-rectal junction.
Figure 2:
Figure 2:
The 10 × 15 cm pre-sacral pelvic mass on sagittal contrast CT.
Figure 3:
Figure 3:
Image of the pelvic mass with the sigmoid reflected.
See this image and copyright information in PMC

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