Presacral myelolipoma: a case report
Spizzirri, A.; Napolitano, V.; La Mura, F.; Cattorini, L.; Farinella, E.; Del Monaco, P.; Migliaccio, C.; Pressi, E.; De Sol, A.; Bravetti, M.; Coccetta, M.; Cirocchi, R.; Sciannameo, F.
Il Giornale di Chirurgia 31(10): 451-455
2010
ISSN/ISBN: 0391-9005 PMID: 20939954 Document Number: 643866
Presacral tumors are more frequently benign, and only occasionally malignant, showing a slow growth and an incidence of 1:40.000. They are asymptomatic in the 26-50% of the cases. When symptoms occur, these are related to the dimensions of the tumor, to its location and to the presence of infection. We report the case of a 69-year old woman with a lower abdominal pain associated with paresthesia and ipostenia of the right inferior limb. Digital rectal examination showed a fixed, mild tender and hard tumor of the posterior rectal wall. CT, MR and CT-guided biopsy sequently performed revealed a solid, dishomogeneous mass, located in the presacral region, with a connective likely origin, without pelvic lymphoadenopathy. The operation allowed to esteem a mass which was tenaciously adherent to the sacrum. We performed a total excision. Final histological diagnosis was myelolipoma. The Authors' opinion is that the en-bloc resection of these tumors with an anterior surgical approach allows a histological diagnosis of the nature, representing the best treatment for potentially malignant lesions, which are frequently radio and chemo-resistant.