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Retrorectal tumors: a diagnostic and therapeutic challenge
Sean C Glasgow1, Elisa H Birnbaum, Jennifer K Lowney
1Department of Surgery, Section of Colon and Rectal Surgery, Siteman Cancer Center, Washington University, St. Louis, Missouri 63110, USA.
Diseases of the Colon and Rectum
|June 7, 2005
Summary
Retrorectal tumors are challenging, with pain, male gender, and age predicting malignancy. While benign tumors are curable, malignant retrorectal tumors often recur after surgery.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Radiology
Background:
- Retrorectal tumors are uncommon and heterogeneous.
- Diagnostic and therapeutic approaches are variable.
- Limited data exists on newer imaging techniques for retrorectal tumors.
Purpose of the Study:
- To examine the diagnosis, treatment, and outcomes of retrorectal tumors.
- To evaluate the utility of imaging modalities in retrorectal tumor management.
- To identify predictors of malignancy in retrorectal tumors.
Main Methods:
- Retrospective review of 34 patients with primary retrorectal neoplasms (1981-2003).
- Inclusion of patients from colorectal surgery and gynecologic oncology services.
- Exclusion of inflammatory processes, advanced colorectal cancer, and metastatic disease.
Main Results:
- Malignancy was present in 21% of cases; older age, male gender, and pain predicted malignancy.
- Transrectal ultrasound achieved 100% sensitivity, surpassing proctoscopy (53%).
- Benign tumors had no recurrence, while all malignant tumors recurred; median survival for malignant cases was 61 months.
Conclusions:
- Retrorectal tumors present diagnostic and therapeutic challenges.
- Imaging aids surgical planning but definitive diagnosis requires pathology.
- Complete resection of benign tumors is achievable, but curative resection of malignant retrorectal tumors is difficult.