Retrorectal Tumors

ABSTRACT

Primary neoplasms of the retrorectal (presacral) space are very rare. These lesions may be congenital or acquired, benign or malignant. They often arise with subtle clinical symptoms, or they may be found incidentally during evaluation for other conditions. Preoperative imaging can provide useful information for operative planning; however, it does not eliminate the need for surgery. Approaches for resection include posterior only and combined abdominoperineal, depending on the characteristics of the lesion. Successful treatment of these enigmatic lesions requires extensive knowledge of pelvic anatomy and expertise in pelvic surgery.

KEYWORDS

Retrorectal tumors - presacral space - chordoma - teratoma

REFERENCES

• 1 Jao S-W, Beart R W, Spencer R J, Reiman H M, Ilstrup D M. Retrorectal tumors: Mayo Clinic experience, 1960-1979.  Dis Colon Rectum. 1985;  28 644-652
• 2 McCune W S. Management of sacrococcygeal tumors.  Ann Surg. 1964;  159 911-918
• 3 Bohm B, Milsom J W, Fazio V W, Lavery I C, Church J M, Oakley J R. Our approach to the management of congenital presacral tumors in adults.  Int J Colorectal Dis. 1993;  8 134-138
• 4 Glasgow S C, Birnbaum E H, Lowney J K et al.. Retrorectal tumors: a diagnostic and therapeutic challenge.  Dis Colon Rectum. 2005;  48 1581-1587
• 5 Singer M A, Cintron J R, Martz J E, Schoetz D J, Abcarian H. Retrorectal cyst: a rare tumor frequently misdiagnosed.  J Am Coll Surg. 2003;  196 880-886
• 6 Barnes F. Pelvic tumor obstructing labor.  Br Med J. 1885;  1 420-422
• 7 Page F. Large extraperitoneal dermoid cyst successfully removed through an incision across the perineum, midway between the anus and the coccyx.  Br Med J. 1891;  1 406-409
• 8 Lisco H. Malignant tumors developing in sacrococcygeal teratomata.  Ann Surg. 1942;  115 378-389
• 9 Neal M P, Carlisle J B. Congenital sacrococcygeal tumors, a case report of teratoma.  South Med J. 1943;  36 677
• 10 Kraske P. Zur exstirpation hochsitzender Mastdarmkrebse.  Arch Klin Chir. 1886;  33 563
• 11 Bowers R F. Giant cell tumor of the sacrum-case report.  Ann Surg. 1948;  128 1164-1172
• 12 Lev-Chelouche D, Gutman M, Goldman G et al.. Presacral tumors: a practical classification and treatment of a unique and heterogenous group of diseases.  Surgery. 2003;  133 473-478
• 13 Ludwig K A, Reynolds H L. Retrorectal tumors.  Clin Colon Rectal Surg. 2002;  15 285-293
• 14 Abel M E, Nelson R, Prasad M L, Pearl R K, Orsay C P, Abcarian H. Parasacrococcygeal approach for the resection of retrorectal developmental cysts.  Dis Colon Rectum. 1985;  28 855-858
• 15 Springall R G, Griffiths J D. Malignant change in retrorectal duplication.  J R Soc Med. 1990;  83 185-186
• 16 Pantoja E, Rodriguez-Ibanez I. Sacrococcygeal dermoids and teratomas: historical review.  Am J Surg. 1976;  132 377-383
• 17 Baratti D, Gronchi A, Pennacchioli E et al.. Chordoma: natural history and results in 28 patients treated at a single institution.  Ann Surg Oncol. 2003;  10 291-296
• 18 Anderson F M, Burke B L. Anterior sacral meningocele: a presentation of three cases.  JAMA. 1977;  237 39-42
• 19 Cody III H S, Marcove R C, Quan S H. Malignant retrorectal tumors: 28 years' experience at Memorial Sloan-Kettering Cancer Center.  Dis Colon Rectum. 1981;  24 501-506
• 20 Horenstein M G, Erlandson R A, Gonzalez-Cueto D M, Rosai  J. Presacral carcinoid tumors: report of three cases and review of the literature.  Am J Surg Pathol. 1998;  22 251-255
• 21 Mourra N, Caplin S, Parc R, Flejou J-F. Presacral neuroendocrine carcinoma developed in a tailgut cyst.  Dis Colon Rectum. 2003;  46 411-413
• 22 Edelstein P S, Wong W D, La Valleur J, Rothenberger D A. Carcinoid tumor: an extremely unusual presacral lesion.  Dis Colon Rectum. 1996;  39 938-942
• 23 Oren M, Lorber B, Lee S H et al.. Anterior sacral meningocele: report of five cases and review of the literature.  Dis Colon Rectum. 1977;  20 492-505
• 24 Uhlig B E, Johnson R L. Presacral tumors and cysts in adults.  Dis Colon Rectum. 1975;  18 581-596
• 25 Kovalcik P J, Burke J B. Anterior sacral meningocele and the scimitar sign: report of a case.  Dis Colon Rectum. 1988;  31 806-807
• 26 Freier D T, Stanley J C, Thompson N W. Retrorectal tumors in adults.  Surg Gynecol Obstet. 1971;  132 681-686
• 27 Ng E W, Porcu P, Loehrer P J. Sacrococcygeal teratoma in adults: case reports and a review of the literature.  Cancer. 1999;  86 1198-1202
• 28 Amendola B, Amendola M, Oliver E, McClatchey K. Chordoma: role of radiation therapy.  Radiology. 1986;  158 839-843