Surgical Treatment of Neuroepithelial Tumours of the Central Surface of the Sacrum –  Case Reports

Authors: P. Vaněk 1;  D. Erhart 2;  T. Belšan 3;  P. Hrabal 4;  V. Beneš 1
Authors‘ workplace: ÚVN Praha Neurochirurgická klinika 1. LF UK v Praze 1;  ÚVN Praha Chirurgická klinika 2. LF UK v Praze 2;  ÚVN Praha Radiodiagnostické oddělení 3;  ÚVN Praha Patologicko-anatomické oddělení 4
Published in: Cesk Slov Neurol N 2010; 73/106(3): 0
Category: Case Report


The authors present case reports of the course of therapy for two patients who underwent surgery for extensive neuroepithelial tumours located on the ventral surface of the sacrum. In the first case‑ report, resection of the tumour with an anterior transperitoneal approach is described, and in the second case report a tumour resection with a posterior trans‑sacral approach was referred. The discussion that follows centres around the clinical manifestation of the disease resulting from presacral expansions. Differential diagnosis after detection of the expansion of the sacrum and radiological findings are mentioned. Surgical strategy and treatment after surgery, together with follow‑up strategy, are discussed.

Key words:
neurofibroma – ganglioneuroma – presacral tumour – transperitoneal approach – transsacral approach


1. Strouhal E, Nemecková A. Paleopathological find of a sacral neurilemmoma from ancient Egypt. Am J Phys Antropol 2004; 125(4): 320– 328.

2. Rasmussen TB, Kernohan JW, Adson AW. Pathologic consideration, with surgical consideration, of intraspinal tumors. Ann Surg 1940; 111(4): 513– 530.

3. Whitaker LD, Pemberton JD. Tumors ventral to the sacrum. Ann Surg 1938; 107(1): 96– 106.

4. Klimo P jr, Rao G, Schmidt RH, Schmidt MH. Nerve sheath tumors involving the sacrum. Neurosurg Focus 2003; 15(2): 12.

5. Feldenzer JA, McGauley JL, McGillicudy JE. Sacral and presacral tumors: problem in diagnosis and management. Neurosurgery 1989; 25(6): 884– 891.

6. Abernathey CD, Onofrio BM, Scheithauer B. Surgical management of giant sacral schwannomas. J Neurosurg 1986; 65(3): 286– 295.

7. Stewart RJ, Humphreys WG, Parks TG. The presentation and management of presacral tumours. Br J Surg 1986; 73(2): 153– 155.

8. Domínguez J, Lobato RD, Ramos A, Rival JJ, Gómez PA, Castro S. Giant intrasacral schwannomas: report of six cases. Acta Neurochir 1997; 139(10): 954– 960.

9. Turner ML, Mulhern CB, Dalinka MK. Lesion of the sacrum. Differential diagnosis and radiological evaluation. JAMA 1981; 245(3): 275– 279.

10. Popuri R, Davies AM. MR imaging features of giant presacral schwannomas: a report of four cases. Eur Radiol 2002; 12(9): 2365– 2369.

11. Cerullo G, Marrelli D, Rampone B, Miracco C, Caruso S, di Martino M, Mazzei MA et al. Presacral ganglioneuroma: a case report and review of literature. World J Gastroenterol 2007; 13(14): 2129– 2131.

12. Patocskai EJ, Tabatabaian M, Thomas MJ. Cellular schwannoma: rare presacral tumor. Can J Surg 2001; 45(2): 141– 144.

13. Wuisman P, Härle A, Mathiass HH, Roessner A, Erlemann R, Reiser M. Two‑stage therapy in the treatment of sacral tumors. Arch Orthop Trauma Surg 1989; 108(4): 255– 260.

14. Regan JF, Juler GL, Schmutzer KJ. Retroperitoneal neurilemoma. Am J Surg 1977; 134(1): 140– 145.

Paediatric neurology Neurosurgery Neurology

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