Presacral Tumors
6 results
1 - 6
Malignancy- A 34-year-old patient presents with vague pelvic discomfort. Digital rectal examination (DRE) reveals a 3-cm anterior soft, compressible lesion that is 4 cm from the anal verge. Pelvic magnetic resonance imaging (MRI) shows a presacral solid mass that measures 2.5 cm x 2 cm with its most proximal part at S3 level. There is a clear plane between the lesion and the rectum anteriorly and the sacrum posteriorly. What is the best next step in treatment of this patient?
- A 34-year-old female patient presents with an incidental imaging finding of the cyst, as seen in the figures below. Which of the following is the most appropriate approach for removal?
- An otherwise healthy 50-year-old patient reports rectal fullness and pain while sitting. On examination, the rectal mucosa is smooth; however, you can palpate a large firm mass that appears extraluminal and extends to the tip of your examining finger. Cross-sectional imaging reveals a large heterogeneous presacral mass that measures 7 cm x 10 cm. The best next step in management is
- A 60-year-old man is referred for a finding of a 4-cm presacral mass during the workup for leg pain. Magnetic resonance imaging (MRI) shows an enhancing, heterogenous 4-cm mass with irregular margins and osseous destruction. What is the most common cause of this lesion?
- A 68-year-old woman reports severe anal pain and bleeding. Examination demonstrates a 2-cm ulcerated lesion just proximal to the dentate line. Biopsies reveal BRAF mutation anal melanoma. Imaging demonstrates enlarged presacral and obturator lymph nodes. The best next step in management is
- A 63-year-old woman is diagnosed with a poorly differentiated microsatellite–stable rectal cancer 7 cm from the anal verge on screening colonoscopy. She denies trouble with continence. Staging computed tomography (CT) of the chest/abdomen/pelvis does not demonstrate distant disease; a mass is confirmed in the mid rectum with evidence of lymphadenopathy. Rectal magnetic resonance imaging (MRI) demonstrates this tumor is a T4aN2M0 with threatened circumferential radial margin. The multidisciplinary tumor board recommends total neoadjuvant chemotherapy with FOLFOX and long-course chemoradiation therapy. Six weeks after completing neoadjuvant therapy, flexible sigmoidoscopy demonstrates persistent tumor. Restaging MRI after total neoadjuvant therapy is consistent with persistently threatened posterior radial margin with tumor extending to the presacral fascia. The multidisciplinary tumor board’s best recommendation for her is