Management of Tumors of the Ischiorectal Fossa: The Role of Percutaneous Biopsy.
Dis Colon Rectum
; 58(10): 938-42, 2015 Oct.
Article
in En
| MEDLINE
| ID: mdl-26347965
ABSTRACT
BACKGROUND:
Noninflammatory masses in the ischiorectal fossa are rare.OBJECTIVE:
This study aimed to review our experience with ischiorectal fossa tumors and to address the question of whether percutaneous biopsy should be undertaken.DESIGN:
This is a retrospective study. SETTINGS This study was conducted at a tertiary institution. PATIENTS From April 2007 to November 2014, all consecutive ischiorectal fossa masses treated in a referral center were retrospectively reviewed. They were all presented and discussed in a multidisciplinary team meeting. Magnetic resonance imaging was performed in all the patients. Inflammatory pathologies, such as abscess, were excluded from the analysis.INTERVENTIONS:
Percutaneous biopsy and surgical excision of ischiorectal fossa tumors were reviewed. MAIN OUTCOMEMEASURES:
Perioperative, pathological, and oncological outcomes were measured.RESULTS:
Eleven patients were identified (8 female; median age, 50 years; range, 25-90). Percutaneous biopsy was undertaken in 8 patients. All biopsies were diagnostic and altered preoperative management in 3 cases (aggressive angiomyxoma (n = 2), desmoid fibromatosis (n = 1)). Overall final diagnosis was benign in 3 patients, locally aggressive neoplasm in 3, and malignant in 5 cases (leiomyosarcomas (n = 2), liposarcomas (n = 2), and angiomyosarcoma (n = 1)). Surgical approaches were perineal in 8 patients, abdominoperineal in 1 patient, and totally abdominal in 1 patient. One patient (age 90 years) was managed nonsurgically. After resection, 2 positive margins were observed (R1 rate, 20%). After a mean follow-up of 24.3 months, 3 patients have experienced local recurrence, which required further surgery in 2 cases.LIMITATIONS:
This study is limited by the small number of patients.CONCLUSIONS:
Noninflammatory masses in the ischiorectal fossa are rare, but they are commonly malignant and should be imaged by MRI. Unless the radiological appearances are diagnostic, percutaneous biopsy is recommended and alters management in about one-third of cases.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pelvic Neoplasms
/
Biopsy
/
Fibromatosis, Aggressive
/
Myxoma
/
Neoplasm Recurrence, Local
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Dis Colon Rectum
Year:
2015
Document type:
Article
Affiliation country:
Reino Unido