From 1981 to 1990, we experienced 10 cases of sacral and presacral tumor at the Department of Surgery, Seoul National University Hospital and performed clinical analysis on these 10 cases.
1) Seven patients were female and 3 were male, showing female preponderence. The age ranged from 23 to 59 years(the mean age: 33 years).
2) Seven cases were presacral tumors and the other three cases were sacral tumors.
3) Seven cases were benign tumors and the others were malignant tumors. Among benign tumors, there were 3 cases of neurilemmoma, 2 cases of dermoid cyst, and 1 cases of teratoma and hemangiopericytoma respectively. Three malignant tumors were
osteosarcoma, chondrosarcoma and giant cell tumor.
4) The most notable clinical features were palpable mass and pain.
5) Total excision of mass was performed in 5 cases of benign tumor by anterior approach. In the patient with benign teratoma, excision of mass and resection of coccyx and S5 were performed by posterior approach. In one patient with dermoid cyst,
excision of mass was performed by parasacrococcygeal approach. One patient with malignant tumor received Miles' operation and resection of coccyx and S4.5 by abdominosacral approach. But only palliative colostomy was possible in the other two
patients
with malignant tumor.
6) The mean value of maximum diameter of mass was 10cm. That of malignant tumors was 11cm that of benign tumors 9.5cm.
7) Adjuvant chemotherapy was performed in the patient with osteosarcoma. Adjuvant radiotherapy was performed in the patients with chondrosacoma and giant cell tumor. The patient with liposarcoma received combined chemotherapy and radiotherapy.
8) Five patients with follow-up lost. All three patients of malignant tumor were dead(the median survival was 6 months).
9) We think that the more aggressive surgical approach is recommended for sacral and presacal tumor which looks "unresectabel" for anatomical pecularity. And it must be determined later that the more aggressive surgical approach has prolonged
the
survival rate of these patients.
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