AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of re...AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.展开更多
Tailgut cyst, also called retrorectal hamartoma, is a rare congenital lesion and is usually located anterior to the sacrum and posterior to the rectum. We report a case of double tailgut cyst (presacral and precoccyge...Tailgut cyst, also called retrorectal hamartoma, is a rare congenital lesion and is usually located anterior to the sacrum and posterior to the rectum. We report a case of double tailgut cyst (presacral and precoccygeal hamartoma). A 62-year- old female visited the hospital complaining of anal pain and pressure in the perianal area for one month. Digital rectal examination revealed a round mass with hard consistency in the lateral and posterior part of rectum 5 cm from the anal verge. Pelvic magnetic resonance imaging showed two cystic and solid presacral masses (lateral and posterior part of rectum) compressing the rectum. The patient underwent surgical resection for pathologic diagnosis. At operation, two masses were located in the left presacral space without invasion to adjacent organs and soft tissue. Pathologic examination revealed double tailgut cysts without malignant transformation. A differential diagnosis of perirectal cystic hamartoma includes epidermal cysts, cystic teratomas, dermoid cysts, anal gland cysts, sarcoma and rectal duplications. Regional inflammatory process frequently complicates this lesion and perirectal fistula can develop. Tailgut cyst also has a malignancy potential, with development of adenocarcinomas. To establish a definite diagnosis and prevent complication, complete surgical resection is recommended.展开更多
BACKGROUND Primary neuroendocrine tumors (NETs) in the presacral region are extremely rare, some of which are caused by other primary tumors or metastatic rectal carcinoids. Nevertheless, cases of NETs have been incre...BACKGROUND Primary neuroendocrine tumors (NETs) in the presacral region are extremely rare, some of which are caused by other primary tumors or metastatic rectal carcinoids. Nevertheless, cases of NETs have been increasing in recent years. This report describes the first primary neuroendocrine tumor in the presacral region that was found at our hospital within the last five years. CASE SUMMARY The patient was identified as a 36-year-old woman with a presacral mass and pelvic floor pain. A digital rectal examination revealed a presacral mass with unclear margins and obvious tenderness. Magnetic resonance imaging (MRI) demonstrated a 57 mm × 29 mm presacral lump. An ultrasound-guided needle biopsy confirmed a well-differentiated neuroendocrine tumor. No other primary or metastatic tumors were found. CONCLUSION Comprehensive consideration of our case report and literature reported by others suggests that a conclusive diagnosis of NETs should be based on computed tomography/MRI and pathological examinations. The treatment of primary NETs in the presacral region mainly relies on surgical procedures with follow-up.展开更多
Aim: Presacral lesions are uncommon and represent a diagnostic and surgical challenge. The aim of this study is to present our experience with Kraske’s transsacral resection and to review current literature. Methods:...Aim: Presacral lesions are uncommon and represent a diagnostic and surgical challenge. The aim of this study is to present our experience with Kraske’s transsacral resection and to review current literature. Methods: Seven patients who had a transsacral resection between 2001 and 2013?were reviewed retrospectively. Results: Two men and five women with a mean age of 39 (range 17?- 60) years were diagnosed with a presacral lesion. The clinical presentation was nonspecific;pain was the most common symptom. All lesions were palpable on digital rectal examination. Magnetic resonance imaging (MRI) was necessary to assess the tumor’s extent, biological behavior and relationship to adjacent structures. MRI predicted malignancy with 100% accuracy. All lesions were located below S3 and underwent a transsacral resection. Pathological examination revealed four tailgut cysts, two epidermoid cysts and one chordoma. Postoperative complications included wound infections (two cases) and spasms of the gluteus muscle (one case). We reported no recurrence or mortality. Conclusion: Clinical awareness, the use of MRI in the routine work-up and avoidance of an incisional biopsy result in a good outcome after surgical resection of presacral lesions. Kraske’s approach can be used for presacral lesions below S3, resulting in low morbidity, no recurrence and no mortality.展开更多
Retrorectal(also known as presacral) tumor(RT) is a rare disease of retrorectal space. They can be classified as congenital, inflammatory, neurogenic, osseous, or miscellaneous. The most common presentation is an asym...Retrorectal(also known as presacral) tumor(RT) is a rare disease of retrorectal space. They can be classified as congenital, inflammatory, neurogenic, osseous, or miscellaneous. The most common presentation is an asymptomatic mass discovered on routine rectal examination, but certain nonspecific symptoms can be elicited by careful history and physical examination. The primary and only satisfactory treatment is surgery for RTs. Three approaches commonly used for resection are abdominal, transsacral, or a combined abdominosacral approach. Prognosis is directly related primary local control, which is often difficult to achieve for malignantlesions.展开更多
文摘AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.
文摘Tailgut cyst, also called retrorectal hamartoma, is a rare congenital lesion and is usually located anterior to the sacrum and posterior to the rectum. We report a case of double tailgut cyst (presacral and precoccygeal hamartoma). A 62-year- old female visited the hospital complaining of anal pain and pressure in the perianal area for one month. Digital rectal examination revealed a round mass with hard consistency in the lateral and posterior part of rectum 5 cm from the anal verge. Pelvic magnetic resonance imaging showed two cystic and solid presacral masses (lateral and posterior part of rectum) compressing the rectum. The patient underwent surgical resection for pathologic diagnosis. At operation, two masses were located in the left presacral space without invasion to adjacent organs and soft tissue. Pathologic examination revealed double tailgut cysts without malignant transformation. A differential diagnosis of perirectal cystic hamartoma includes epidermal cysts, cystic teratomas, dermoid cysts, anal gland cysts, sarcoma and rectal duplications. Regional inflammatory process frequently complicates this lesion and perirectal fistula can develop. Tailgut cyst also has a malignancy potential, with development of adenocarcinomas. To establish a definite diagnosis and prevent complication, complete surgical resection is recommended.
基金Supported by Nanjing Municipal Health Bureau,No.ZKX15040Nanjing Medical Science and Technology Development Foundation,No.NWQR-201702
文摘BACKGROUND Primary neuroendocrine tumors (NETs) in the presacral region are extremely rare, some of which are caused by other primary tumors or metastatic rectal carcinoids. Nevertheless, cases of NETs have been increasing in recent years. This report describes the first primary neuroendocrine tumor in the presacral region that was found at our hospital within the last five years. CASE SUMMARY The patient was identified as a 36-year-old woman with a presacral mass and pelvic floor pain. A digital rectal examination revealed a presacral mass with unclear margins and obvious tenderness. Magnetic resonance imaging (MRI) demonstrated a 57 mm × 29 mm presacral lump. An ultrasound-guided needle biopsy confirmed a well-differentiated neuroendocrine tumor. No other primary or metastatic tumors were found. CONCLUSION Comprehensive consideration of our case report and literature reported by others suggests that a conclusive diagnosis of NETs should be based on computed tomography/MRI and pathological examinations. The treatment of primary NETs in the presacral region mainly relies on surgical procedures with follow-up.
文摘Aim: Presacral lesions are uncommon and represent a diagnostic and surgical challenge. The aim of this study is to present our experience with Kraske’s transsacral resection and to review current literature. Methods: Seven patients who had a transsacral resection between 2001 and 2013?were reviewed retrospectively. Results: Two men and five women with a mean age of 39 (range 17?- 60) years were diagnosed with a presacral lesion. The clinical presentation was nonspecific;pain was the most common symptom. All lesions were palpable on digital rectal examination. Magnetic resonance imaging (MRI) was necessary to assess the tumor’s extent, biological behavior and relationship to adjacent structures. MRI predicted malignancy with 100% accuracy. All lesions were located below S3 and underwent a transsacral resection. Pathological examination revealed four tailgut cysts, two epidermoid cysts and one chordoma. Postoperative complications included wound infections (two cases) and spasms of the gluteus muscle (one case). We reported no recurrence or mortality. Conclusion: Clinical awareness, the use of MRI in the routine work-up and avoidance of an incisional biopsy result in a good outcome after surgical resection of presacral lesions. Kraske’s approach can be used for presacral lesions below S3, resulting in low morbidity, no recurrence and no mortality.
文摘Retrorectal(also known as presacral) tumor(RT) is a rare disease of retrorectal space. They can be classified as congenital, inflammatory, neurogenic, osseous, or miscellaneous. The most common presentation is an asymptomatic mass discovered on routine rectal examination, but certain nonspecific symptoms can be elicited by careful history and physical examination. The primary and only satisfactory treatment is surgery for RTs. Three approaches commonly used for resection are abdominal, transsacral, or a combined abdominosacral approach. Prognosis is directly related primary local control, which is often difficult to achieve for malignantlesions.
