Introduction: Presacral tumors are a rare and little known pathology. We present our experience in its surgical treatment.
Methods: Analysis of a series (1995-2008).
Results: 20 patients (14 women and 6 men), average age 46 (29-71) years. Patients with benign tumors were younger (43.5+/-10.2) years that those who had malignant tumors (62+/-10.7; p = 0.002). The median duration of symptoms was 1 year (2 month-50 years). The first symptom was suppuration, palpable mass or constipation in 10 cases or constipation, abdominal pain in 4, back pain in 4 and a casual finding in 3. The surgical approach was perineal in 9 (45%), abdominal in 8 (40%) and combined in 3 (15%) cases. Fifteen (75%) tumors were benign, with teratomas being the most frequent (5 cases). Another 5 were malignant: 2 chordomas, 1 malignant cystic teratoma, 1 malignant mucinous cystadenocarcinoma and 1 lymphoma. Mean postoperative stay was 6.6+/-5 days. There were post-surgical complications in 5 (20%) patients. After an average follow-up of 3.5+/-4 years, 2 patients died (malignant teratoma and cystadenocarcinoma, respectively) due to morbidity and to a non-resectable recurrence, and a benign schwannoma has recurred, the rest being free of disease.
Conclusions: Surgical treatment by a group of surgeons experienced in perineal and pelvic surgery can obtain good results with few complications, with the exception of some malignant tumors, depending on the infiltration of adjacent structures and their histological type.