Presacral Tumors
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Presacral Tumors- Outcomes
- Key Concepts
- Conclusions
- References
- Introduction
- Anatomic Considerations
- Clinical Presentations
- Physical Examination
- Imaging Studies
- Preoperative Biopsy
- Classification
- Currarino Syndrome
- Epidermoid and Dermoid Cysts
- Tailgut Cysts
- Enterogenous Cysts
- Teratomas
- Chordomas
- Meningoceles
- Neurogenic Tumors
- Osseous Tumors
- Miscellaneous Lesions
- Management
Malignancy- A 65-year-old woman presents with a presacral mass incidentally identified on a lumbar spine magnetic resonance imaging scan. The patient reports back pain but denies any constitutional or gastrointestinal symptoms. On digital rectal examination, the mass is not palpable. Her most recent colonoscopy was 2 years ago and was negative for intraluminal pathology. Imaging reveals a 4-cm cystic lesion located above the S4 level (Figure). What is the best next step in management?
- A 45-year-old woman presents to the clinic with a 4-month history of progressively worsening low back pain, particularly with sitting. Rectal examination reveals a palpable posterior retrorectal mass 5 cm from the anal verge. Flexible sigmoidoscopy reveals a bulge in the posterior rectum, but normal overlying mucosa. Magnetic resonance imaging reveals a 4.5-cm well-circumscribed, solid mass in the presacral space, concerning for a neurogenic tumor. Which of the following is the most appropriate route of biopsy?
- A 40-year-old woman presents to your office with constipation and vague lower back pain. On digital rectal examination, you palpate a smooth mass posteriorly at the tip of your finger. Colonoscopy findings were normal, save for posterior bulging with smooth mucosa in the rectum. Magnetic resonance imaging (MRI) shows a solid mass in the rectorectal space with bony destruction of the sacrum. What is the next best management step for this patient?
Malignancy- 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?
- 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?
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