TITLE:
Surgical Excision of Ischiorectal Fossa Tumors
AUTHORS:
Javier Die Trill, Juan Carlos García, Irene Moreno, Juan Diego Pina, Estela Tobaruela, Jose Barquin, Juan Ocaña, Antonio Rey
KEYWORDS:
Ischiorectal Fossa Tumors, Aggressive Angiomyxoma
JOURNAL NAME:
Surgical Science,
Vol.7 No.10,
October
19,
2016
ABSTRACT: Background: Ischiorectal Fossa Tumors are rare and their management has not been protocolized. Patients: We
retrospectively review four consecutive cases treated in our department, from
January 2015 to July 2015. All of them were discussed in a multidisciplinary
team meeting. None of them were secondary to an inflammatory process. Results:
A Magnetic Resonance Imaging was performed in all the four patients, and as it
was not a malignant diagnosis made in any of them, we proceeded to resecate the lesions. None biopsies were
performed and the benign diagnoses were confirmed by the pathologist.
All the patients underwent a local posterior or perineal approach, because all
the lesions (epidermoid cyst, hamartoma, lipoma and an aggressive
angiomyxoma) were localized purely in the ischiorectal fossa, under the levator ani muscle and not invading any adjacent structures. In all of them, an R0 resection was performed. Conclusions: Ischiorectal fossa tumors
are rare and there are few cases already published. Non-inflammatory
lesions located in the ischiorectal fossa, with none
invasion of rectum or levator ani muscle, are mainly benign
lesions prone to their complete excision by a posterior approach. Biopsy is not
always necessary unless there’s a suspicion of a malignancy or invasion of
adjacent structures, and only in that case a biopsy should be made, because
in some of them, a neo-adjuvant treatment can be
useful to reduce the tumor and to perform an R0 resection.