Managing Recurrent Teratoma in Currarino Syndrome

Abstract

To the best of our knowledge, this is the first reported case of a recurrent presacral tumor in Currarino syndrome. Currarino syndrome is a rare disease usually found in childhood with a triad of sacral agenesis, anorectal malformation, and presacral tumor. However, it can often remain undiscovered until adulthood. Currarino syndrome is generally diagnosed during childhood in the setting of recurrent meningitis and is often suspected when there is a family history. Occasionally, it is diagnosed in adulthood through incidental imaging or due to investigations for back pain and chronic constipation. MRI is the recommended imaging modality in this disease process, as it can better help differentiate soft tissue. The tumor can be resected through either the transabdominal approach or the posterior approach (Kraske procedure). We present a 52-year-old female patient who was diagnosed with Currarino syndrome when she was one year old due to recurrent meningitis and surgical resection of a presacral mass and was asymptomatic until she developed back pain and constipation. Her symptoms were investigated with an MRI, revealing a recurrence of a presacral tumor, and she subsequently underwent a Kraske procedure. The patient is currently under annual surveillance, and the residual tumor has remained stable. There are currently no surveillance guidelines after resection of a presacral tumor in Currarino Syndrome. However, follow-up surveillance should be considered.

Keywords: case report; colorectal surgery; currarino syndrome; recurrence; teratoma.

Figure 1. Preoperative magnetic resonance imaging of recurrent teratoma measuring 61 mm × 48 mm × 57 mm (C) (T2, Sagittal Slice 2019).

Figure 2. Noncontrast computed tomography intravenous pyelogram sagittal 2016. Teratoma measuring 54 mm × 49 mm × 46 mm (C).

Figure 3. MRI pelvis T2: two-year post-resection of presacral tumor measuring 13 mm × 31 mm × 8 mm (C).