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Tumors of the Retrorectal Space

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Diseases of the Colon & Rectum

PURPOSE

Retrorectal tumors are a diverse group of masses derived from a variety of embryologic origins. Because of this, some confusion is associated with their diagnosis and management. Although rare, a basic understanding of the etiology, presentation, work-up, and treatment of retrorectal masses is essential.

METHODS

The incidence, classification, diagnosis, treatment, and prognosis of these masses are presented. A comprehensive review of the literature is included in our analysis.

RESULTS

Retrorectal lesions can be classified as congenital, inflammatory, neurogenic, osseous, or miscellaneous. Benign and malignant lesions behave similarly. The most common presentation is an asymptomatic mass discovered on routine rectal examination, but certain nonspecific symptoms can be elicited by careful history. Biopsy of these lesions should be avoided to prevent tumor seeding, fecal fistula, meningitis, and abscess formation. Complete surgical resection, usually after appropriate specialized imaging, remains the cornerstone of their treatment. Three approaches commonly used for resection are abdominal, transsacral, or a combined abdominosacral approach. Prognosis is directly related primarily to local control, which often is difficult to achieve for malignant lesions.

CONCLUSIONS

Retrorectal masses present a challenging surgical problem from diagnosis to treatment. A high index of suspicion and resultant early diagnosis, followed by thorough preoperative planning, is required for optimal management and outcome.

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REFERENCES

  1. BE Uhlig RL Johnson (1975) ArticleTitlePresacral tumors and cysts in adults Dis Colon Rectum 18 581–9 Occurrence Handle1181162

    PubMed  Google Scholar 

  2. HS Cody Suffix3rd RC Marcove SH Quan (1981) ArticleTitleMalignant retrorectal tumors: 28 years' experience at Memorial Sloan- Kettering Cancer Center Dis Colon Rectum 24 501–6 Occurrence Handle7297357

    PubMed  Google Scholar 

  3. SW Jao RW Beart SuffixJr RJ Spencer HM Reiman DM Ilstrup (1985) ArticleTitleRetrorectal tumors. Mayo Clinic experience, 1960–1979 Dis Colon Rectum 28 644–52 Occurrence Handle2996861

    PubMed  Google Scholar 

  4. B Bohm JW Milsom VW Fazio IC Lavery JM Church JR Oakley (1993) ArticleTitleOur approach to the management of congenital presacral tumors in adults Int J Colorectal Dis 8 134–8 Occurrence Handle10.1007/BF00341185 Occurrence Handle8245668

    Article  PubMed  Google Scholar 

  5. DT Freier JC Stanley NW Thompson (1971) ArticleTitleRetrorectal tumors in adults Surg Gynecol Obstet 132 681–6 Occurrence Handle4995717

    PubMed  Google Scholar 

  6. F Migliorelli P Cooper J McElhinney (1967) ArticleTitleUnusual presacrococcygeal cystic tumors Am J Surg 113 777–82 Occurrence Handle10.1016/0002-9610(67)90346-7 Occurrence Handle6023916

    Article  PubMed  Google Scholar 

  7. RC Jackman ND Smith (1951) ArticleTitleRetrorectal tumors JAMA 145 959–62

    Google Scholar 

  8. RJ Stewart WG Humphreys TG Parks (1986) ArticleTitleThe presentation and management of presacral tumours Br J Surg 73 153–5 Occurrence Handle3947908

    PubMed  Google Scholar 

  9. DJ Killen (1964) ArticleTitleSacrococcygeal teratoma in the adult Arch Surg 88 425–31 Occurrence Handle14088272

    PubMed  Google Scholar 

  10. RM Miles GS Stewart SuffixJr (1974) ArticleTitleSacrococcygeal teratomas in adult Ann Surg 179 676–83 Occurrence Handle4823844

    PubMed  Google Scholar 

  11. ML McMaster AM Goldstein CM Bromley N Ishibe DM Parry (2001) ArticleTitleChordoma: incidence and survival patterns in the United States, 1973–1995 Cancer Causes Control 12 1–11 Occurrence Handle10.1023/A:1008947301735 Occurrence Handle11227920

    Article  PubMed  Google Scholar 

  12. EY Cheng RA Ozerdemoglu EE Transfeldt RC Thompson SuffixJr (1999) ArticleTitleLumbosacral chordoma. Prognostic factors and treatment Spine 24 1639–45 Occurrence Handle10.1097/00007632-199908150-00004 Occurrence Handle10472097

    Article  PubMed  Google Scholar 

  13. SW Gray B Singhabhandhu RA Smith JE Skandalakis (1975) ArticleTitleSacrococcygeal chordoma: report of a case and review of the literature Surgery 78 573–82 Occurrence Handle1188599

    PubMed  Google Scholar 

  14. P Bergh LG Kindblom B Gunterberg F Remotti W Ryd JM Meis-Kindblom (2000) ArticleTitlePrognostic factors in chordoma of the sacrum and mobile spine: a study of 39 patients Cancer 88 2122–34 Occurrence Handle10.1002/(SICI)1097-0142(20000501)88:9<2122::AID-CNCR19>3.0.CO;2-1 Occurrence Handle10813725

    Article  PubMed  Google Scholar 

  15. BM Hjermstad EB Helwig (1988) ArticleTitleTailgut cysts. Report of 53 cases Am J Clin Pathol 89 139–47 Occurrence Handle3277378

    PubMed  Google Scholar 

  16. RJ Spencer (1962) ArticleTitleSurgical management of precoccygeal cysts Surg Gynecol Obstet 115 449–52 Occurrence Handle13915701

    PubMed  Google Scholar 

  17. M Edwards (1961) ArticleTitleMultilocular retrorectal cystic disease—cyst-hamartoma: report of twelve cases Dis Colon Rectum 4 103–10

    Google Scholar 

  18. WJ Hawkins (1953) ArticleTitleDevelopmental cysts as a source of perianal abscesses, sinuses and fistulas Am J Surg 86 678–83 Occurrence Handle10.1016/0002-9610(53)90377-8 Occurrence Handle13104773

    Article  PubMed  Google Scholar 

  19. SA Localio K Eng JH Ranson (1980) ArticleTitleAbdominosacral approach for retrorectal tumors Ann Surg 191 555–60 Occurrence Handle6929181

    PubMed  Google Scholar 

  20. CW Sobrado M Mester OS Simonsen CR Justo JN deAbreu A Habr-Gama (1996) ArticleTitleRetrorectal tumors complicating pregnancy. Report of two cases Dis Colon Rectum 39 1176–9 Occurrence Handle10.1007/BF02081422 Occurrence Handle8831537

    Article  PubMed  Google Scholar 

  21. AR Johnson PR Ros BM Hjermstad (1986) ArticleTitleTailgut cyst: diagnosis with CT and sonography AJR Am J Roentgenol 147 1309–11 Occurrence Handle3535460

    PubMed  Google Scholar 

  22. G Verazin L Rosen IT Khubchandani JA Sheets JJ Stasik R Riether (1986) ArticleTitleRetrorectal tumor: is biopsy risky? South Med J 79 1437–9 Occurrence Handle2877499

    PubMed  Google Scholar 

  23. M Oren B Lorber SH Lee RC Truex SuffixJr AR Gennaro (1977) ArticleTitleAnterior sacral meningocele: report of five cases and review of the literature Dis Colon Rectum 20 492–505 Occurrence Handle143361

    PubMed  Google Scholar 

  24. CS MacCarty JM Waugh MB Coventry WF Cope SuffixJr (1965) ArticleTitleSurgical treatment of sacral and presacral tumors other than sacrococcygeal chordoma J Neurosurg 22 458–64 Occurrence Handle5825608

    PubMed  Google Scholar 

  25. ME Abel R Nelson ML Prasad RK Pearl CP Orsay H Abcarian (1985) ArticleTitleParasacrococcygeal approach for the resection of retrorectal developmental cysts Dis Colon Rectum 28 855–8 Occurrence Handle4053899

    PubMed  Google Scholar 

  26. D Fourney Z Gokaslan (2003) ArticleTitleCurrent management of sacral chordoma Neurosurg Focus 15 IssueID2 E9

    Google Scholar 

  27. PL Althausen PD Schneider RJ Bold et al. (2002) ArticleTitleMultimodality management of a giant cell tumor arising in the proximal sacrum: case report Spine 27 E361–5 Occurrence Handle10.1097/00007632-200208010-00020 Occurrence Handle12163737

    Article  PubMed  Google Scholar 

  28. K Tomita H Tsuchiya (1990) ArticleTitleTotal sacrectomy and reconstruction for huge sacral tumors Spine 15 1223–7 Occurrence Handle2267620

    PubMed  Google Scholar 

  29. B Gunterberg (1976) ArticleTitleEffects of major resection of the sacrum Acta Orthop Scand 162 9–38

    Google Scholar 

  30. B Gunterberg J Kewenter I Petersen B Stener (1976) ArticleTitleAnorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves Br J Surg 63 546–54 Occurrence Handle953450

    PubMed  Google Scholar 

  31. B Gunterberg L Norlen B Stener T Sundin (1975) ArticleTitleNeurologic evaluation after resection of the sacrum Invest Urol 13 183–8 Occurrence Handle1193815

    PubMed  Google Scholar 

  32. B Gunterberg J Kewenter I Petersen B Stener (1976) ArticleTitleAnorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves Br J Surg 63 546–54 Occurrence Handle953450

    PubMed  Google Scholar 

  33. WK Miles DW Chang SS Kroll et al. (2000) ArticleTitleReconstruction of large sacral defects following total sacrectomy Plast Reconstr Surg 105 2387–94 Occurrence Handle10845291

    PubMed  Google Scholar 

  34. BE Amendola MA Amendola E Oliver KD McClatchey (1986) ArticleTitleChordoma: role of radiation therapy Radiology 158 839–43 Occurrence Handle3945761

    PubMed  Google Scholar 

  35. N Breteau M Demasure A Favre R Leloup J Lescrainier R Sabattier (1996) ArticleTitleFast neutron therapy for inoperable or recurrent sacrococcygeal chordomas Bull Cancer Radiother 83 142s–5 Occurrence Handle8949767

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of California Davis Medical Center, Sacramento, California

    Kristina G. Hobson M.D., Vafa Ghaemmaghami M.D., John P. Roe M.D., James E. Goodnight M.D. & Vijay P. Khatri M.D.

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  1. Kristina G. Hobson M.D.
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  2. Vafa Ghaemmaghami M.D.
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  3. John P. Roe M.D.
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  4. James E. Goodnight M.D.
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  5. Vijay P. Khatri M.D.
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Corresponding author

Correspondence to Vijay P. Khatri M.D..

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Hobson, K., Ghaemmaghami, V., Roe, J. et al. Tumors of the Retrorectal Space. Dis Colon Rectum 48, 1964–1974 (2005). https://doi.org/10.1007/s10350-005-0122-9

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