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Presacral tumors: how do they compare in pediatric and adult patients?
Insights
Presacral tumors present differently in children and adults, with distinct symptoms and tumor types. Understanding these differences is key for effective management and treatment of these rare conditions.
Area of Science:
- Oncology
- Pediatric Oncology
- Surgical Pathology
Background:
- Presacral tumors are rare, with limited research on age-related differences.
- Optimal management strategies for pediatric versus adult presacral tumors remain unclear.
Purpose of the Study:
- To compare the clinical presentation, surgical treatment, pathology, and recurrence rates of presacral tumors in pediatric and adult patients.
- To identify potential differences that may influence management decisions.
Main Methods:
- A retrospective chart review of patients with presacral tumors treated at a tertiary referral center from 1981 to 2011.
- Patients were stratified into pediatric (<18 years) and adult (≥18 years) groups for comparative analysis.
Main Results:
- Pediatric patients most commonly presented with a mass, while adults experienced pain.
- Teratomas were the most frequent pediatric tumor, contrasting with hamartomas/tailgut cysts in adults.
- Recurrence rates were 21% in pediatric and 24% in adult patients; metastasis occurred in 14% of pediatric and 8% of adult cases.
Conclusions:
- Presacral tumor characteristics, including presentation and histology, differ significantly between pediatric and adult populations.
- Recognizing these age-specific variations is crucial for tailoring the evaluation and management of presacral tumors.
Unlabelled:
Presacral tumors are rare with few published studies in the literature. It is unknown whether the course of the disease and the required treatment differs between pediatric and adult patients. The aim of the study was to compare presenting symptoms, surgical treatment, pathology, and recurrence rates of presacral tumors in these two groups.
Material And Methods:
An IRB-approved chart review was conducted for patients diagnosed with a presacral tumor at the Cleveland Clinic between 1981 and 2011. Symptoms, physical exam, surgical details, tumor histology, and outcomes were collected as part of the review. Patients were divided into two groups: pediatric (< 18 years n=14) and adult (≥ 18 years n=50).
Results:
The most common symptom was a mass in pediatric and pain in adult patients. The most common pediatric primary tumor was a teratoma (n=5, 36%) versus Hamartoma/tailgut cyst (n=17, 34%) in adult patients. Three pediatric and nine adult patients developed tumor recurrences, and 2/14 (14%) pediatric and 4/50 (8%) adult patients developed metastases.
Conclusions:
This study summarizes the presentation, evaluation and management of pediatric and adult presacral tumors at tertiary referral center. The presentation, histology, and management of presacral tumors vary depending upon whether they occur in pediatric or adult patients and recognition of potential differences may influence management.
