Engin ÖLÇÜCÜOĞLU, Alpaslan ŞAHİN
Turkish Journal of Colorectal Disease - 2026;36(2):41-48
Aim: Retrorectal tumors represent a rare and heterogeneous group of presacral lesions with diverse embryologic origins and pathologic features. Their deep pelvic location and often non-specific presentation pose challenges for both diagnosis and operative planning, and surgical decision-making is frequently guided by anatomy and imaging rather than robust comparative evidence. Method: We retrospectively reviewed adult patients who underwent surgical resection for primary retrorectal tumors between 2016 and 2025 at a tertiary referral center. Preoperative assessment relied mainly on magnetic resonance imaging, with the choice of surgical approach determined by tumor extent in relation to the S3 vertebral level. Demographic data, operative details, histopathologic findings, and postoperative outcomes were evaluated. Results: The study included 16 patients, with a mean age of 48.3+/-14.2 years and a predominance of female patients. Most tumors were located below the S3 level and were treated via a posterior approach, whereas anterior or combined approaches were selected for lesions with cranial extension. Congenital lesions were most common, whereas malignant tumors accounted for 31.2% of cases and consisted exclusively of chordomas. Macroscopically complete resection was achieved in all patients; one chordoma demonstrated microscopic margin involvement. Postoperative complications were generally low grade, no perioperative mortality occurred, and tumor recurrence was observed in a single patient during follow-up. Conclusion: This single-center experience suggests that preoperative imaging and anatomical considerations may assist surgical planning and enable safe tumor resection in patients with retrorectal tumors.
