Presacral Tumor

(Retrorectal Tumor)


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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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

Presacral tumors are more common in women.


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


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 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.


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


America Cancer Society
American Society of Colon and Rectal Surgeons


Canadian Cancer Society


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: Accessed January 29, 2021.
Last reviewed September 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP

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