A 27×18 cm Solitary Fibrous Tumor Derived from the Mesorectum Resected by Transsacral followed by Abdominal Approach —A Case Report—

Abstract

A 48 year-old man was referred to our hospital because of a huge pelvic tumor. His past medical history included hypertension. Laboratory findings were unremarkable, and an abdominal computed tomography (CT) scan showed a huge “well-demarcated” pelvic mass measured 20 cm in size. Neither distant metastases nor involvement of other organs were seen. Needle biopsy was performed to make the histopathological diagnosis. Then a solitary fibrous tumor (SFT) was diagnosed. An angiography revealed that the tumor was fed only by the inferior mesenteric artery. So we performed resection of the tumor with the patient in the Jack-knife position via the transsacral followed by abdominal approach. The rectum associated with part of the sigmoid colon was dissected at the anal side of the tumor, and the tumor was exfoliated from the pelvic wall through transsacral approach prior to abdominal resection. The duration of the operation was 8 hours and 5 minutes, and blood loss was 1,135ml.

Even huge SFTs like in our case can safely be removed by operation preceded by the transsacral approach that certify the operative vision and space.