title: Incidence and Operative Excision of Presacral Masses: An Institutional Analysis.
abstract: Presacral masses are rare lesions that encompass a broad range of pathologic findings. Most presacral masses are benign. The aim of this study was to analyze the clinical presentation, pathology, and surgical treatment of presacral masses at a single academic institution over a decade. In this retrospective study, we reviewed all surgically excised presacral tumors between 2003 and 2013. Clinical and pathologic data were recorded. Thirteen patients had surgical excision of a presacral mass. The median age was 42 years (standard deviation ± 19.7) and average follow-up was 11.9 months (standard deviation ± 17.5). The majority of patients were symptomatic. Forty-six per cent (6/13) had sacral or rectal pain. Thirty-eight per cent (5/13) of patients had a palpable mass on digital rectal examination. Sixty-nine per cent of patients had an MRI, 84.6 per cent a CT, and 61.5 per cent multimodality imaging. Most presacral masses were benign (10/13, 77%). Twenty-three per cent (3/13) were malignant. A majority were excised via posterior approach (9/13, 69%), but 31 per cent (4/13) required an anterior or combined approach. Presacral masses are rare, even at a high-volume tertiary care center. They are commonly evaluated with a multiple imaging modalities, are most likely benign, and can be excised via posterior approach.
authors.affiliation: Department of Surgery, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hiller
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Waters
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Bohl
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D009657:North Carolina / Q000453:epidemiology; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed