[Diagnosis and treatment of sacral and retrorectal tumors. II]

Forty-three sacral and retrorectal tumors encountered at the Cleveland Clinic were reviewed, with emphasis on incidence, diagnosis, and management. Benign tumors could be differentiated from malignant lesions on the basis of history, physical examination, and radiologic studies. CT scan and Magnetic Resonance Imaging are the most useful tests for staging. Small benign tumors may be removed through a posterior approach. All malignant lesions, and benign lesions greater than 3-4 cm in size should be removed through a combined anterior and posterior approach. All tumors should be completely removed wherever possible, since both benign and malignant tumors will recur when excision is incomplete. Radiotherapy and chemotherapy may provide some palliation for malignant tumors, but these modalities are not curative in our experience.