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Congress: ECR25
Poster Number: C-17418
Type: Poster: EPOS Radiologist (educational)
Authorblock: I. Goel, P. Kaushik; Delhi/IN
Disclosures:
Ishan Goel: Nothing to disclose
Parul Kaushik: Nothing to disclose
Keywords: Abdomen, Paediatric, Pelvis, CT, MR, Ultrasound-Colour Doppler, Diagnostic procedure, Structured reporting, Cysts, Education and training, Neoplasia
Learning objectives To review the spectrum of radiological findings in pediatric retro-rectal/ presacral masses. To outline the specific imaging pointers with respect to both nature as well as anatomical origin and extent of these lesions Further using these findings, to reinforce an imaging based surgically relevant differential diagnostic approach.
Read more Background Presacral location is a potential extraperitoneal space in pelvis, with a complex positional anatomy. [fig 1] Unique embryological anatomy : Primordial germ cell, mesenchymal, neural, vascular, osseous or lymphatic origins. Constellation of findings on Diagnostic Imaging : CT and/or MR coupled with USG findings serve as highly effective tools in diagnosing, delineating anatomic extent and associated complications while being minimally invasive at the same time. Selection of optimal surgical approach : Anterior, posterior, or combined;  based on the lesion extent and relationship to adjacent structures on...
Read more Findings and procedure details Identification of Key imaging pointers within the pediatric presacral masses to formulate a diagnostic strategy : Nature of lesion : Cystic or Solid or Mixed Fat content within the lesion : Present or Absent Sacral involvement: Present or Absent [fig 2] [fig 3] Identification of Key anatomical pointers within the pediatric presacral masses to assist the treatment strategy : Lesion is above or below S3 level: important landmark for surgical approach Neurovasculature involvement (iliac and sacral vessels, cauda equina and sacral nerve roots) [fig 4] TAIL GUT AND RECTAL DUPLICATION...
Read more Conclusion Imaging features and qualitative nature of the presacral lesions provide a practical perspective/ guide. towards diagnostic differentials and Radiologist must be aware of the same. Anatomical information provided from imaging aids in selecting the right surgical approach for resection and management. Reporting checklist should be followed for a definitve diagnosis and should include: Tumor location & relationship to adjacent structures midline vs lateral Impact on or displacement of the rectum, bladder, uterus, or other pelvic organs Involvement of the sacrum and coccyx (spared or erosion or...
Read more References Otote J, El Butnari V, Ravichandran PS, et al (2024) Presacral tumors: A systematic review of literature. J Clin Imaging Sci. 2024;14:17 Hosseini-Nik H, Hosseinzadeh K, Bhayana R, et al (2015) MR imaging of the retrorectal-presacral tumors. Abdom Imaging (2015) 40:2630–2644 Reiter MJ, Schwope RB, Bui-Mansfield LT, Lisanti CJ, et al (2015) Surgical Management of Retrorectal Lesions. AJR 2015 204:2, 386-395 Dozois, E.J., Marcos, M.D.H. Presacral Tumors. In: Beck, D.E., Roberts, et al (2011) The ASCRS Textbook of Colon and Rectal Surgery.
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