Tumours of the retrorectal space: management and outcome of a heterogeneous group of diseases

Abstract

Given their complexity, these tumours should be addressed by experts and all treatment options must be contemplated. They continue to present a challenge, above all in malignant tumours where the tumour cannot be controlled at a locoregional level.

The Value of Preoperative Biopsy in the Management of Solid Presacral Tumors

“…4 in contrast, although solid tumors can be both benign and malignant, many are malignant with a wide range of pathologic subtypes, which complicates their management. [3][4][5][6][7][8] an accurate preoperative diagnosis of solid or heterogeneous tumors in the presacral space is crucial, because the clinical management of benign and malignant lesions differs considerably. surgically, a wide-margin, en-bloc oncologic resection is indicated for most malignant lesions, but a close-margin approach should be attempted for benign lesions to spare function and avoid morbidity.…”

Surgical management of a retro-rectal cystic hamartoma (tailgut cyst) using a trans-rectal approach: a case report and review of the literature

“…Despite the fact that the majority of tailgut cysts are benign, the current literature shows an increasing risk of malignant transformation [7,13] when the most common histopathologic diagnoses are adenocarcinoma or carcinoid [13]. Interestingly, malignancy is more common in men due to delay in diagnosis; this is because among women the cystic lesions are frequently detected during gynecological examinations [9]. …”

“…MRI findings usually correlate slightly more with the final histology of the tumor than CT scan results. Of course, primarily patients must undergo a digital rectal examination and colonoscopy (and additionally, for women, a gynecological examination) to exclude more common conditions [3,9]. Final diagnosis, of course, remains histopathologic [13], but most authors agree that a pre-operative biopsy of the tumor is not indicated because it can be uninformative and the risk of bleeding, infection and dissemination of malignant cells into the peritoneal cavity or seeding of the biopsy tract is high [7,11].…”

“…Final diagnosis, of course, remains histopathologic [13], but most authors agree that a pre-operative biopsy of the tumor is not indicated because it can be uninformative and the risk of bleeding, infection and dissemination of malignant cells into the peritoneal cavity or seeding of the biopsy tract is high [7,11]. Complete surgical excision of the epithelial lining with clear resection margins remains the cornerstone option for surgical management of tumors in the retro-rectal space [7,11,13], even if asymptomatic, but treatment may be very challenging when cystic lesions are associated with a fistula or abscess and especially when adjacent structures are involved (sacrum, rectum, blood vessels and nerves) or when the disease is not correctly diagnosed at presentation [7,9]. Furthermore, the risks of recurrence, hemorrhage, chronic infection and malignant degeneration to adenocarcinoma or squamous carcinoma always exists [13].…”

Retrorectal tumour simulating vaginal birth: an exceptional case of emergency surgery indication

“…The differential diagnosis is wide and includes a congenital origin in most of cases and neurogenic, osseous or inflammatory origin 2. Congenital cystic lesions are the most common, and they represent up to 40% of retrorectal tumours.…”