Mseddi Mohamed Ali, Siala Rakia, Yaakoubi Chaima, Saad Sarra, Zeheni Kassar Alia, Nouri Takwa, Guizeni Rami, Sassi Karim, Ben Slima Mohamed
General Surgery Department "B", La Rabta Hospital, The Faculty of Medicine, The University of Tunis El Manar, Tunis, Tunisia.
Department of Anatamopathology, La Rabta Hospital, The Faculty of Medicine, The University of Tunis El Manar, Tunis, Tunisia.
Ann Med Surg (Lond). 2024 Oct 23;86(12):7330-7333. doi: 10.1097/MS9.0000000000002658. eCollection 2024 Dec.
Deep-located glomangiomas are rarely reported. Because of their scarcity, treatment strategy is hard to establish. Herein, the authors report the first case to our knowledge of pre-sacral glomangioma.
A 34-year-old female patient, with no previous medical history, consulted for 2-month-old pelvic abdominal pain, vomiting and delayed menstruation. Her physical and biological parameters were with no abnormalities. MRI of the pelvis demonstrated a 14 cm mixed heterogeneous pre-sacral lesion pushing the rectum anteriorly. She was operated on via a laparoscopic approach. Division of Douglas' pouch and pelvic peritoneum laterally to the bladder showcased a cystic lesion of 13×8 cm occupying the pelvis while deviating the rectum anteriorly. Its content was aspirated and left membrane was extracted in a sac. The postoperative course was uneventful.
Pre-sacral masses are hard to treat because of their large heterogeneity. Surgical resection should be tempted to retrieve the definitive histological diagnosis and relieve the patient. However, the surgical route is controversial as each approach has its advantages. Thus, the surgical route should take into consideration the lesion's size, height and surrounding contacts, the patient's functional state and surgeon's expertise.
Pre-sacral glomangiomas carries a low malignant pattern but should be resected to offer histological diagnosis. The surgical route remains at the surgeon's decision, with the main objective to totally resect the encountered lesion without causing functional and sexual complications or harm to surrounding viscera.
深部球血管瘤鲜有报道。因其罕见，难以制定治疗策略。在此，作者报道了我们所知的首例骶前球血管瘤病例。
一名34岁女性患者，既往无病史，因两个月的盆腔腹痛、呕吐及月经推迟前来就诊。她的身体和生物学参数均无异常。骨盆磁共振成像显示一个14厘米的骶前混合性异质性病变，将直肠向前推。她通过腹腔镜手术进行治疗。在膀胱外侧分离Douglas窝和盆腔腹膜，展示出一个13×8厘米的囊性病变，占据盆腔并使直肠向前移位。抽出其内容物，将残留包膜从囊中取出。术后过程顺利。
骶前肿物因其高度异质性而难以治疗。应尝试手术切除以获得明确的组织学诊断并缓解患者症状。然而，手术途径存在争议，因为每种方法都有其优点。因此，手术途径应考虑病变的大小、高度和周围毗邻关系、患者的功能状态以及外科医生的专业技能。
骶前球血管瘤恶性程度低，但应进行切除以提供组织学诊断。手术途径仍由外科医生决定，主要目标是完全切除所遇到的病变，而不引起功能和性方面的并发症或对周围脏器造成损害。
