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. 2015:12:37-40.
doi: 10.1016/j.ijscr.2015.05.015. Epub 2015 May 12.

Management of presacral tumors: Our experience with posterior approach

Dhananjay Saxena  1 , Abhinav Pandey  2 , Rajendra Prasad Bugalia  3 , Mahendra Kumar  4 , Raju Kadam  5 , Vipul Agarwal  6 , Amit Goyal  7 , Jeevan Kankaria  8 , Raj Kamal Jenaw  9
Affiliations

Management of presacral tumors: Our experience with posterior approach

Dhananjay Saxena et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Presacral tumors are a rare variety of space occupying lesions arising in the presacral space. Most of the tumors are congenital in origin. Due to obscure anatomic location, difficult surgical approach and etiological heterogeneity, tumors arising here pose a diagnostic and therapeutic challenge. We report our experience of 10 cases of presacral tumors with posterior approach being used in 6.

Materials and methods: A retrospective analysis was conducted on 10 cases of presacral tumors managed at our hospital during a period of 14 months (May 2013-July 2014). 9 cases were operated while one had advanced disease and was referred for palliative care. Complete en bloc excision of the mass was possible in 8 cases. Finally, presenting complaints, clinical diagnosis, surgical procedure and histopahological findings of the cases were studied.

Results: All of our patients were females in the age group of 18-50 (mean 28.4) years. The pathological findings included schwannoma, leiomyosarcoma, hemangiopericytoma, neurofibroma, paraganglioma and rest were developmental cysts. 6 cases were managed using the posterior approach and rest by anterior approach. There was no major complication or mortality in the follow up.

Conclusion: Complete surgical excision remains the mainstay of therapy. Surgical approach depends upon the location, size, local invasion and surgical expertise of the surgeon. Benign tumors have a good prognosis while the prognosis in malignant tumors remains guarded due to difficulty in obtaining safe resection margins. Posterior approach is an attractive option for low lying, benign tumors that is more direct, with better exposure and quicker recovery.

Keywords: Posterior approach; Presacral tumors.

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Figures

Fig. 1
Fig. 1
Preoperative photograph of the patient 7 showing swelling over lower back.
Fig. 2
Fig. 2
MRI abdomen and pelvis of patient 10 showing well defined presacral mass.
Fig. 3
Fig. 3
Post operative photograph showing the transverse incision used for posterior approach.
See this image and copyright information in PMC

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