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A pelvic tumor is any one of numerous tumors that occur in the pelvis. Within the pelvis, these tumors may involve specific organs, or occupy intra-organ spaces. Tumors of the presacral space and sacral space are most prevalent in children. Tumors occupying specific organs have a more complex natural history.
The pelvis is either the lower part of the trunk of the human body between the abdomen and the thighs or the skeleton embedded in it.
In human anatomy, the presacral space is inside the pelvis, behind the rectum and in front of the coccyx and sacrum. Normally it is empty, or it contains a pocket of fat.
Sacrococcygeal teratoma (SCT) is a type of tumor known as a teratoma that develops at the base of the coccyx (tailbone) and is thought to be derived from the primitive streak. Sacrococcygeal teratomas are benign 75% of the time, malignant 12% of the time, and the remainder are considered "immature teratomas" that share benign and malignant features. Benign sacrococcygeal teratomas are more likely to develop in younger children who are less than 5 months old, and older children are more likely to develop malignant sacrococcygeal teratomas. The Currarino triad, due to an autosomal dominant mutation in the MNX1 gene, consists of a presacral mass, anorectal malformation and sacral dysgenesis.
Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms include blood in the urine, pain with urination, and low back pain.
Anal cancer is a cancer which arises from the anus, the distal opening of the gastrointestinal tract. It is a distinct entity from the more common colorectal cancer.
Sacral space (in approximate order of prevalence):
A teratoma is a tumor made up of several different types of tissue, such as hair, muscle, or bone. They typically form in the ovaries, testicles, or tailbone and less commonly in other areas. Symptoms may be minimal if the tumor is small. A testicular teratoma may present as a painless lump. Complications may include ovarian torsion, testicular torsion, or hydrops fetalis.
A lipoma is a benign tumor made of fat tissue. They are generally soft to the touch, movable, and painless. They usually occur just under the skin, but occasionally may be deeper. Most are less than 5 cm in size. Common locations include upper back, shoulders, and abdomen. A few people have a number of lipomas.
Ganglioneuroma is a rare and benign tumor of the autonomic nerve fibers arising from neural crest sympathogonia, which are completely undifferentiated cells of the sympathetic nervous system. However, ganglioneuromas themselves are fully differentiated neuronal tumors that do not contain immature elements.
The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If damaged, most commonly by childbirth, lesions may cause sensory loss or fecal incontinence. The nerve may be temporarily blocked as part of an anaesthetic procedure.
Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. Symptoms may include a lump in the testicle, or swelling or pain in the scrotum. Treatment may result in infertility.
Kidney cancer, also known as renal cancer, is a type of cancer that starts in the cells in the kidney.
An ependymoma is a tumor that arises from the ependyma, a tissue of the central nervous system. Usually, in pediatric cases the location is intracranial, while in adults it is spinal. The common location of intracranial ependymomas is the fourth ventricle. Rarely, ependymomas can occur in the pelvic cavity.
A germ-cell tumor (GCT) is a neoplasm derived from germ cells. Germ-cell tumors can be cancerous or benign. Germ cells normally occur inside the gonads. GCTs that originate outside the gonads may be birth defects resulting from errors during development of the embryo.
The pelvic cavity is a body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet. Its lower boundary is the pelvic floor.
The inferior hypogastric plexus is a plexus of nerves that supplies the viscera of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in females.
Total mesorectal excision (TME) is a standard technique for treatment of colorectal cancer, first described in 1982 by Professor Bill Heald at the UK's Basingstoke District Hospital. A significant length of the bowel around the tumour is removed, as is the surrounding tissue up to the plane between the mesorectum and the presacral fascia. Dissection along this plane facilitates a straightforward dissection and preserves the sacral vessels and hypogastric nerves. It is possible to rejoin the two ends of the colon; however, most patients require a temporary ileostomy pouch to bypass the colon, allowing it to heal with less risk of perforation or leakage.
Ovarian tumors, or ovarian neoplasms, are tumors arising from the ovary. They can be benign or malignant.
The Currarino syndrome is an inherited congenital disorder where either the sacrum is not formed properly, or there is a mass in the presacral space in front of the sacrum, and (3) there are malformations of the anus or rectum. It can also cause an anterior meningocele or a presacral teratoma.
A teratoma is a tumor of germ cell origin, containing tissues from more than one germ cell line. It can be ovarian or testicular in its origin.
The presacral fascia lines the anterior aspect of the sacrum, enclosing the sacral vessels and nerves. It continues anteriorly as the pelvic parietal fascia, covering the entire pelvic cavity.
Overflow incontinence is a form of urinary incontinence, characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition occurs in people who have a blockage of the bladder outlet, or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Overflow incontinence may also be a side effect of certain medications.
Pediatric ependymomas are similar in nature to the adult form of ependymoma in that they are thought to arise from radial glial cells lining the ventricular system. However, they differ from adult ependymomas in which genes and chromosomes are most often affected, the region of the brain they are most frequently found in, and the prognosis of the patients. Children with certain hereditary diseases, such as neurofibromatosis type II (NF2), have been found to be more frequently afflicted with this class of tumors, but a firm genetic link remains to be established. Symptoms associated with the development of pediatric ependymomas are varied, much like symptoms for a number of other pediatric brain tumors including vomiting, headache, irritability, lethargy, and changes in gait. Although younger children and children with invasive tumor types generally experience less favorable outcomes, total removal of the tumors is the most conspicuous prognostic factor for both survival and relapse.
Metanephric dysplastic hematoma of the sacral region (MDHSR) has been described by Cozzutto and Lazzaroni-Fossati in 1980, by Posalaki et al. in 1981 and by Cozzutto et al. in 1982. Three additional cases were seen by Finegold.
Ovarian Germ Cell Tumors (OGCTs) are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad, which accounts for about 2.6% of all ovarian malignancies. There are four main types of OGCTs, namely dysgerminomas, yolk sac tumor, teratoma, and choriocarcinoma. Dygerminomas are the most common type and are particularly prominent in patients diagnosed with gonadal dysgenesis. OGCTs are relatively difficult to detect and diagnose at an early stage because of the nonspecific histological characteristics. Common symptoms of OGCT are bloating, abdominal distention, ascites, and dyspareunia. OGCT is caused mainly due to the formation of malignant cancer cells in the primordial germ cells of the ovary. The exact pathogenesis of OGCTs is still unknown however, various genetic mutations and environmental factors have been identified. OGCTs are commonly found during pregnancy when an adnexal mass is found during a pelvic examination, ultrasound scans show a solid mass in ovary or blood serum test shows elevated alpha-fetoprotein levels. They are unlikely to have metastasized and therefore the standard tumor management is surgical resection, coupled with chemotherapy. The occurrence rate is less than 3 % worldwide.
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