Presacral Tumor

(Retrorectal Tumor)

Definition

The presacral space is the area between the rectum and lowest part of the spine. It's called the sacrum. A tumor is a growth in this area. The tumor can range from a cyst to a mass that invades nearby structures. It can be cancerous, but this is rare.

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Causes    TOP

A presacral tumor may be caused by:

  • Problems that are present from birth
  • Structural defects—can be caused by Currarino syndrome
  • Other forms of cancer that have spread

Risk Factors    TOP

Presacral tumors are more common in women.

Symptoms    TOP

You may not have any problems. In those that have them, symptoms may cause:

  • Pain in the lower back, rectum, or pelvis
  • Pain that spreads down the legs
  • A feeling of heaviness
  • Constipation
  • Urinary incontinence
  • Weight loss

Diagnosis    TOP

The doctor will ask about your symptoms and health history. A physical exam will be done, which includes a digital rectal exam. The doctor will feel for lumps with a lubricated, gloved finger in the rectum. You may also have:

  • Blood tests
  • Urine tests
  • Imaging tests such as:
  • Endoscopy—a lighted scope is placed in the body to view structures
  • Biopsy—a sample of tissue is tested in a lab (not always needed)

Treatment    TOP

Treatment depends on the type of tumor. Options may include:

  • Surgery to remove the tumor.
  • Chemotherapy—The use of drugs to kill cancer cells. It may given by mouth, shots, or IV. The drugs enter the bloodstream and travel throughout the body.
  • Radiation therapy—This may be used along with chemotherapy. Radiation therapy involves using radiation to kill cancer cells and shrink tumors.

Prevention    TOP

There is no way to prevent a presacral tumor since the cause is unknown.

RESOURCES:

America Cancer Society
https://www.cancer.org
American Society of Colon and Rectal Surgeons
https://www.fascrs.org

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca

References:

Hassan I, Wietfeldt ED. Presacral tumors: diagnosis and management. Clin Colon Rectal Surg. 2009;22(2):84-93.
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):240-248.
Presacral tumors. USCF Center for Colorectal Surgery website. Available at: https://colorectal.surgery.ucsf.edu/conditions--procedures/presacral-tumors.aspx. Accessed August 1, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 8/1/2018

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