[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

Università degli Studi di Perugia- Sede di Terni Azienda Pspedaliera, S. Maria- Terni Clinica Chirurgica Generale d d'Urgenza.

G Chir. 2010 Oct;31(10):451-5.

BACKGROUND

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.

CASE REPORT

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.

CONCLUSIONS

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.