Laparoscopic Resection of a Huge Retrorectal Tumor

Retrorectal space tumors are rare, and so are frequently unrecognized, misdiagnosed, and mistreated. A 57-year-old man visited the outpatient clinic with the chief complaints of thin stool and lower pelvic heaviness. A smooth, round huge palpable mass on the right posterolateral rectal wall was detected and pelvic computed tomography showed a 7.8-cm cystic lesion in the right retrorectal space. Laparoscopic procedures were initiated with perirectal dissection for rectal mobilization. After fixation of the peritoneum and tying the rectum for intracorporeal traction, the rectum was mobilized to identify the cyst. The cyst was removed using an endo-bag, with completion of cyst dissection. The final pathologic diagnosis was a tailgut cyst, or retrorectal cystic hamartoma without evidence of malignancy. The patient was discharged without any complications. The patient had no dyschezia or problems with bowel function. Laparoscopic resection is a safe and feasible method for surgical treatment, even for bulky retrorectal tumors, with an early recovery period.

Anal Neoplasms, Presacral Tumors, and Rare Malignancies

An understanding of anal anatomy is essential for optimal management. Patients with anal lesions that appear suspicious or fail to respond to conventional therapy within a month should undergo a biopsy. Premalignant perianal lesions are managed with local excision. Epidermoid carcinoma of the anus is usually managed with chemoradiation. Presacral tumors are managed with excision. This review contains 11 figures, 7 tables, and 53 references. Key words: anal cancer, anterior sacral meningocele, basal cell carcinoma, chordoma, epidermoid carcinoma, high-grade squamous intraepithelial lesions, retrorectal tumor

Colorectal stenting for obstruction due to retrorectal tumor in a patient unsuitable for surgery

Fund of knowledge on palliative treatment of unresectable retrorectal tumors is scare. Here, we reported a non-surgical treatment of a huge retrorectal malignant tumor in an aged and debilitated patient complicated with colorectal obstruction. An 86-year-old male with severe comorbidities was admitted with acute colorectal obstruction owing to an untreated retrorectal malign epithelial tumor. There was a lobulated retrorectal mass, 20 cm × 15 cm at largest size, extending to the superior iliac bifurcation level, caused an obstruction of the rectal lumen. He was not suitable for surgical excision because of the severe comorbidities. Rectal obstruction was palliated by two self-expandable metallic stents. He tolerated the procedures well and post-procedural course was uneventful. After four months, stents were patent and the patient was continent. Stenting for colorectal obstruction owing to a retrorectal tumor can be feasible in patients who are not suitable for surgery (aged, debilitated, advanced tumor). It avoided the surgical trauma to a high-risk patient and ensured the continuity of continence. As far as we know, this was the first report on colorectal stenting for a retrorectal tumor.

Retrorectal Tumors in Adults: A 10-Year Retrospective Study

Due to the rarity and large diversity of the primary retrorectal tumors (RTs), the diagnoses are often difficult and they can be misdiagnosed. We present our experience in light of scarce information available on the clinical manifestations of RTs. The retrospective study included 17 patients diagnosed as RTs between January 2004 and January 2014. Demographic characteristics, length of symptoms, clinical findings, diagnostic methods, evaluations on the treatment procedures and postoperative periods, pathology, complications, and length of hospital stay were recorded. A mean of 1.7 of patients were diagnosed with RTs annually in our hospital. Patients comprised 12 females and 5 males. Pain and discomfort were the most common symptoms at presentation. All the lesions were evaluated by using magnetic resonance imaging (MRI) and computed tomography (CT), and all the patients were treated operatively. Based on the preoperative MRI or CT findings, an anterior approach was performed in 7 patients, a posterior approach in 6 patients, and combined approach in 4 patients. Mean size of tumors was 9.2 ± 4.3 cm. Epidermoid cyst (n = 8) was the most common tumor. Except for 1 case of liposarcoma, 16 tumors were confirmed to be of benign nature in histologic examination. Mean length of hospital stay 12.4 ± 6.8 days. Retrorectal tumors are heterogeneous and lead to diagnostic difficulties. A high index of clinical suspicion is needed for diagnosis. Preoperative imaging may be helpful in determining the course of treatment. Total excision of a retrorectal tumor may alleviate pressure symptoms and confirm the diagnosis.

Retrorectal tumors: report of two cases

Retrorectal tumor is uncommon identity presenting with nonspecific sign and symptoms making difficulty in diagnosis. Benign tumors are more common than malignant. The lesion may be malignant or progress to malignancy from benign state. Retrorectal masses in young women may continue to grow and result in dystocia. Cystic lesions are also at risk of becoming infected, which renders subsequent excision more difficult and increase the risk of recurrence. Cross-sectional imaging is required to determine the extent of resection and the appropriate surgical approach. Surgical removal leads to favorable outcomes for patients with benign purely cystic retrorectal tumors. We report two such benign rectal lesions. ] Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 46-50 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8701