title: Large pelvic masses of obscure origin: urologist's perspective.
abstract: BACKGROUND
  Large pelvic masses pose unique diagnostic and therapeutic challenges due to varied aetiology, paucity of characteristic imaging features, lack of therapeutic algorithms and surgical difficulties in resection inside the narrow confines of the pelvis with close proximity of vital structures.
  
  
  METHODS
  Records of 22 patients with large pelvic masses in the last six years were analysed. Their demographic and clinical features were noted, along with imaging features, preoperative biopsy, surgical procedure, intraoperative difficulties, complications, adjuvant therapy and outcome.
  
  
  RESULTS
  There were 14 men and 8 women with a median age of 45 years. Presenting symptoms were abdominal mass, pain, lower urinary tract symptoms, urinary retention and constipation. Imaging was mostly unable to determine the organ of origin of the tumour. Histopathology revealed pelvic fibromatosis (2), chondrosarcoma (1), liposarcoma (1), haemangioendothelioma (1), lymphangioma (2), fibroleiomyoma (1), leiomyosarcoma (3), schwannoma (4), malignant nerve sheath tumour (1), rectal gastrointestinal stromal tumour (1), retrovesical hydatid cysts (3), sacral chordoma (1) and Ewing's sarcoma (1). In 5 patients complete excision was not possible because of extension into vital structures. Fifteen patients were alive at 1-5 years of follow-up.
  
  
  CONCLUSIONS
  Urologists, being the 'gatekeepers of the pelvis', are usually involved in the management of large pelvic masses. Good outcome can be achieved with careful surgical planning.
authors.affiliation: Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. santoshsp1967jaimatadi@yahoo.co.in
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.forename: Debansu
authors.initials: D
authors.lastname: Sarkar
authors.forename: Seema
authors.initials: S
authors.lastname: Prasad
authors.forename: Vikash
authors.initials: V
authors.lastname: Gupta
authors.forename: Prithwiraj
authors.initials: P
authors.lastname: Ghosala
authors.forename: L
authors.initials: L
authors.lastname: Kaman
authors.forename: T D
authors.initials: TD
authors.lastname: Yadav
authors.forename: Raguram
authors.initials: R
authors.lastname: Ganesamoni
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures; D014572:Urology; D055815:Young Adult