Zusammenfassung
Wir beschreiben den Fall einer retrorektalen Raumforderung, dessen präoperative Diagnostik ein Adenokarzinom ohne Rückschluss auf einen Primarius ergab. Bei supraanaler Lokalisation musste die Rektumexstirpation erwogen werden. Schleimhautbefund, Palpation und Bildgebung legten jedoch das Vorliegen eines retrorektalen Tumors bzw. die Metastase eines Adenokarzinoms nahe, welche jeweils eine lokale Exzision erfordert hätten. Die Anwendung eines stufenweisen operativen Algorithmus unter Berücksichtigung einer schnellschnitthistologischen Begutachtung ermöglichte eine exakt der Entität gerechte Therapie.
Abstract
We present a case of a retrorectal space occupying lesion diagnosed as an adenocarcinoma of unknown primary origin by preoperative histopathology. Localization slightly above the anal sphincter would have required extirpation of the rectum. Rectal palpation, endosonography and radiological imaging, however, suggested a retrorectal tumor or a metastasis of an adenocarcinoma. Both entities would have required local resection. We applied a surgical algorithm including frozen biopsy allowing a stepwise choice of operative procedure from the spectrum in question. The operation performed was thus tailored to the entity of the tumor.
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Krückemeier, K., Barth, P., Peitz, U. et al. Management eines retrorektalen Tumors unter Berücksichtigung einer seltenen Differenzialdiagnose. Chirurg 83, 657–660 (2012). https://doi.org/10.1007/s00104-012-2312-z
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DOI: https://doi.org/10.1007/s00104-012-2312-z