Also referred to as retrorectal tumors, presacral tumors are rare tumors that develop in the area between the rectum and lowest part of the spine (or back of the pelvis) called the sacrum. The tumor can come in a variety of lesions, ranging from a cyst to a mass that can invade surrounding structures. A presacral tumor has the potential for malignant transformation.
When it comes to advanced orthopedic conditions such as musculoskeletal tumors, bone, and soft tissue sarcomas, as well as benign bone and soft tissue growths, an experienced surgical team with training and expertise in advanced musculoskeletal reconstruction can make all the difference. Because of the relative rarity of these conditions, there are a limited number of surgeons like Dr. Daniel C. Allison, internationally recognized in orthopedic oncology and advanced reconstruction, in the country who perform these procedures.
Located in Beverly Hills, Los Angeles, CA, Dr. Allison, orthopedic oncologist, has the unique knowledge and training necessary to safely treat and remove musculoskeletal tumors and then effectively reconstruct the residual bone, joint, and soft tissue in order to cure disease and restore mobility and function.
What are the Symptoms of a Presacral Tumor?
Symptoms are often nonspecific and will depend on the size and location of the tumor. Most benign cysts won’t manifest any symptoms and will simply be discovered during a routine rectal examination. Those with symptoms will typically experience the following:
- Pain located in the lower back, pelvis, or rectum
- Pain that spreads down the legs
- Urinary or fecal incontinence
- Weight loss
- A feeling of heaviness
- Sexual dysfunction or drainage
The doctor will evaluate your medical history and will perform physical exams, specifically a neurologic and musculoskeletal exam, as well as a rectal exam and sigmoidoscopy. Other tests conducted for the diagnosis of a presacral tumor may include:
- Blood test
- Urine test
- Imaging tests (MRI, X-ray, CT scan)
These tests will aid in identifying the type of tumor, size of the tumor, and if there is any invasion of surrounding structures. These tests will help your doctor determine the best treatment plan for the tumor. To learn more about how to diagnose a presacral tumor, visit ncbi.nlm.nih.gov
Treatment Options for Presacral Masses and Tumors
Radiation therapy may be recommended as a treatment for cancerous and noncancerous growths. During the early stages of cancer, it can be used to help reduce the size of the tumor before surgery or to kill cancer cells afterward. Radiation therapy utilizes high-energy X-rays or other waves of energy such as light or heat to kill cancer cells before they grow and spread. There are two types of radiation therapy:
- External Radiation – uses a machine that produces a beam of radiation that targets a specific area of the body
- Internal Radiation – uses a radioactive substance that is placed inside the body through a wire, needle, or catheter either near or directly into the cancer
Chemotherapy is a cancer treatment that uses drugs to prevent cancer cells from growing, either by stopping them from dividing or killing them. Unlike radiation therapy or surgery which only targets specific areas, chemotherapy can work throughout the body. Chemotherapy is typically administered directly into the veins by injection or in pill form. Other application methods include:
- Depending on the tumor’s location, chemotherapy can be delivered directly into the tumor. If undergoing surgery, your surgeon can implant slow-dissolving discs that will release medications over time.
- Chemotherapy creams
- Liquid chemotherapy medication that is administered through an IV
- Chemotherapy injected into an artery that goes directly to the cancer. This is called intra-arterial or IA chemotherapy.
Surgery is usually the recommended treatment for presacral tumors, and it is also often used to conduct the proper diagnosis. The surgical procedure is called a pelvic excision or pelvic resection. The approach will depend on the nature and location of the tumor. If it’s located high in the space between the sacrum and rectum, an incision will be made in the abdomen. For lower lesions, on the other hand, an incision will be made in the back between the tailbone and rectum in order to remove the presacral lesion.
Because of the condition’s rarity, only a few surgeons have the technical skill, training, and significant experience in treating these complicated cases. The surgical treatment of presacral tumors will require multi-disciplinary care, and Daniel Allison, MD, FACS will likely work with a colorectal surgeon to perform the sophisticated procedure.
The treatment of orthopedic tumors is a uniquely specialized discipline, and Dr. Allison and his multi-disciplinary team are among the few orthopedic oncology practitioners devoted to treating benign and malignant problems within this medical niche.
Schedule a Consultation with an Orthopedic Oncology Specialist in Los Angeles
As an orthopedic oncologist, Dr. Allison has the advanced skills to diagnose and treat extremity cancers and has intimate knowledge of extremity anatomy, limb preservation, and function that are essential in orthopedic tumor treatment. To learn more or to schedule a personal consultation, contact our Beverly Hills, Los Angeles, CA office today or call (310) 730-8008.