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2013 | 85 | 5 | 253-261
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Presacral Tumors: How do They Compare in Pediatric and Adult Patients?

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Presacral tumors are rare with few published studies in the literature. It is unknown whether the course of the disease and the required treatment differs between pediatric and adult patients.The aim of the study was to compare presenting symptoms, surgical treatment, pathology, and recurrence rates of presacral tumors in these two groups.Material and methods. An IRB-approved chart review was conducted for patients diagnosed with a presacral tumor at the Cleveland Clinic between 1981 and 2011. Symptoms, physical exam, surgical details, tumor histology, and outcomes were collected as part of the review. Patients were divided into two groups: pediatric (< 18 years n=14) and adult (> 18 years n=50).Results. The most common symptom was a mass in pediatric and pain in adult patients. The most common pediatric primary tumor was a teratoma (n=5, 36%) versus Hamartoma/tailgut cyst (n=17, 34%) in adult patients. Three pediatric and nine adult patients developed tumor recurrences, and 2/14 (14%) pediatric and 4/50 (8%) adult patients developed metastases.Conclusions. This study summarizes the presentation, evaluation and management of pediatric and adult presacral tumors at tertiary referral center. The presentation, histology, and management of presacral tumors vary depending upon whether they occur in pediatric or adult patients and recognition of potential differences may influence management.
Physical description
1 - 05 - 2013
12 - 06 - 2013
  • Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic
  • Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic
  • Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic
  • 1. Mazreku A, Karaj A, Avdia I et al.: The presentation and management of presacral tumors. ActaChir Iugosl 2010; 57(2): 55-59.[Crossref]
  • 2. Cody HS, 3rd, Marcove RC , Quan SH: Malignant retrorectal tumors: 28 years’ experience at Memorial Sloan-Kettering Cancer Center. Dis ColonRectum 1981; 24(7): 501-06.
  • 3. Jao SW, Beart RW , Jr., Spencer RJ et al.: Retrorectal tumors. Mayo Clinic experience, 1960-1979. Dis Colon Rectum 1985; 28(9): 644-52.
  • 4. Bohm B, Milsom JW, Fazio VW et al.: Our approach to the management of congenital presacral tumors in adults. Int J Colorectal Dis 1993; 8(3): 134-38.[PubMed][Crossref]
  • 5. Stewart RJ, Humphreys WG, Parks TG: The presentation and management of presacral tumours. Br J Surg 1986; 73(2): 153-55.[Crossref]
  • 6. Gabra HO, Jesudason EC , McDowell HP et al.: Sacrococcygeal teratoma - a 25-year experience in a UK regional center. J Pediatr Surg 2006; 41(9): 1513-16.[Crossref]
  • 7. Ho KO , Soundappan SV, Walker K et al.: Sacrococcygeal teratoma: the 13-year experience of a tertiary paediatric centre. J Paediatr Child Health 2011; 47(5): 287-91.[WoS][Crossref]
  • 8. Isaacs H, Jr: Congenital and neonatal malignant tumors. A 28-year experience at Children’s Hospital of Los Angeles. Am J Pediatr Hematol Oncol 1987; 9(2): 121-29.[Crossref]
  • 9. Kocaoglu M, Frush DP: Pediatric presacral masses. Radiographics 2006; 26(3): 833-57.[PubMed][Crossref]
  • 10. Scherrer JL: The United Nations Convention on the Rights of the Child as policy and strategy for social work action in child welfare in the United States. Soc Work 2012; 57(1): 11-22.[WoS][Crossref]
  • 11. Uhlig BE , Johnson RL: Presacral tumors and cysts in adults. Dis Colon Rectum 1975; 18(7): 581-89.[PubMed][Crossref]
  • 12. Hobson KG, Ghaemmaghami V, Roe JP et al.: Tumors of the retrorectal space. Dis Colon Rectum 2005; 48(10): 1964-74.[Crossref][PubMed]
  • 13. Lev-Chelouche D, Gutman M, Goldman G et al.: Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases. Surgery 2003; 133(5): 473-78.
  • 14. Pidala MJ, Eisenstat TE , Rubin RJ et al.: Presacral cysts: transrectal excision in select patients. Am Surg 1999; 65(2): 112-15.[PubMed]
  • 15. Brindley GV: Sacral and Presacral Tumors. AnnSurg 1945; 121(5): 721-34.
  • 16. Wolpert A, Beer-Gabel M, Lifschitz O et al.: The management of presacral masses in the adult. TechColoproctol 2002; 6(1): 43-49.
  • 17. Ludwig K: Trans-Sacral Approaches for Presacral Cyst/Rectal Tumor. Operative Techniques inGeneral Surgery 2005: 126-36.
  • 18. Glasgow SC, Birnbaum EH, Lowney JK et al.: Retrorectal tumors: a diagnostic and therapeutic challenge. Dis Colon Rectum 2005; 48(8): 1581-87.[PubMed][Crossref]
  • 19. Fan M, Peng Q, Wang XY et al.: (CT and MRI manifestations of pediatric presacral tumors). AiZheng 2009; 28(4): 420-24.
  • 20. Yang BL, Gu YF, Shao WJ et al.: Retrorectal tumors in adults: magnetic resonance imaging findings. World J Gastroenterol 2010; 16(46): 5822-29.[Crossref][PubMed]
  • 21. Coco C, Manno A, Mattana C et al.: Congenital tumors of the retrorectal space in the adult: report of two cases and review of the literature. Tumori 2008; 94(4): 602-07.[PubMed]
  • 22. Ghosh J, Eglinton T, Frizelle FA et al.: Presacral tumours in adults. Surgeon 2007; 5(1): 31-18.[PubMed][Crossref]
  • 23. Localio SA, Eng K, Ranson JH: Abdominosacral approach for retrorectal tumors. Ann Surg 1980; 191(5): 555-60.[PubMed][Crossref]
  • 24. Negro F, Mercuri M, Ricciardi V et al.: Presacral epidermoid cyst. A case report. Ann Ital Chir 2006; 77(1): 75-77.
  • 25. Yang DM, Kim HC, Lee HL et al.: Squamous cell carcinoma arising from a presacral epidermoid cyst: CT and MR findings. Abdom Imaging 2008; 33(4): 498-500.[Crossref][WoS]
  • 26. Pappalardo G, Frattaroli FM, Casciani E et al.: Retrorectal tumors: the choice of surgical approach based on a new classification. Am Surg 2009; 75(3): 240-48.[PubMed]
  • 27. Buchs N, Taylor S, Roche B: The posterior approach for low retrorectal tumors in adults. Int JColorectal Dis 2007; 22(4): 381-85.[WoS][Crossref]
  • 28. Zoller S, Joos A, Dinter D et al.: Retrorectal tumors: excision by transanal endoscopic microsurgery. Rev Esp Enferm Dig 2007; 99(9): 547-50.[PubMed]
  • 29. Marinello FG, Targarona EM, Luppi CR et al.: Laparoscopic approach to retrorectal tumors: review of the literature and report of 4 cases. Surg LaparoscEndosc Percutan Tech 2011; 21(1): 10-13.
  • 30. Bax NM, van der Zee DC: The laparoscopic approach to sacrococcygeal teratomas. Surg Endosc 2004; 18(1): 128-30.
  • 31. Hjermstad BM, Helwig EB : Tailgut cysts. Report of 53 cases. Am J Clin Pathol 1988; 89(2): 139-47.
  • 32. Abubakar AM, Nggada HA, Chinda JY: Sacrococcygeal teratoma in Northeastern Nigeria: 18- years experience. Pediatr Surg Int 2005; 21(8): 645-48. [Crossref]
  • 33. Chirdan LB, Uba AF, Pam SD et al.: Sacrococcygeal teratoma: clinical characteristics and longterm outcome in Nigerian children. Ann Afr Med 2009; 8(2): 105-09.[Crossref]
  • 34. Vega Menendez D, Quintans Rodriguez A, HernandezGranados P et al.: (Tailgut cysts). Cir Esp 2008; 83(2): 53-60.
  • 35. Guillem P, Ernst O, Herjean M et al.: (Retrorectal tumors: an assessment of the abdominal approach). Ann Chir 2001; 126(2): 138-42.[Crossref]
  • 36. Singer MA, Cintron JR, Martz JE et al.: Retrorectal cyst: a rare tumor frequently misdiagnosed. J Am Coll Surg 2003; 196(6): 880-86.[Crossref]
  • 37. Rapport RL, 2nd, Ferguson GS: Dorsal approach to presacral biopsy: technical case report. Neurosurgery 1997; 40(5): 1087-88.[Crossref]
  • 38. Shapiro SA: Malignant sacrococcygeal teratoma. Med Pediatr Oncol 1980; 8(2): 171-75. [PubMed][Crossref]
  • 39. Raney RB , Jr., Chatten J, Littman P et al.: Treatment strategies for infants with malignant sacrococcygeal teratoma. J Pediatr Surg 1981; 16(4 Suppl 1): 573-77.[Crossref]
  • 40. Bittmann S, Bittmann V: Surgical experience and cosmetic outcomes in children with sacrococcygeal teratoma. Curr Surg 2006; 63(1): 51-54.[Crossref][PubMed]
  • 41. Freier DT, Stanley JC, Thompson NW: Retrorectal tumors in adults. Surg Gynecol Obstet 1971; 132(4): 681-86.[PubMed]
  • 42. Ackerman L, Van Drunen M, Reyes CV: Case report 836: Malignant large cell lymphoma of sacrum. Skeletal Radiol 1994; 23(3): 232-35.[PubMed]
  • 43. Bakshi NA, Ross CW , Finn WG et al.: ALKpositive anaplastic large cell lymphoma with primary bone involvement in children. Am J ClinPathol 2006; 125(1): 57-63.
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