Our Summary

This research paper talks about a 29-year-old woman who had repeated lower belly pain that got worse after childbirth. She was found to have a bunch of cysts near her rectum through ultrasound and CT scan. Before surgery, tests were done to ensure the normal functioning and health of her pudendal nerve, which controls the pelvic muscles. The cysts were then removed using a Da Vinci Xi robotic system, a high-tech surgical tool. The woman recovered without any issues, and her symptoms completely disappeared.

The paper notes that these kinds of cysts usually develop in the presacral space, an area at the base of the spine, due to incomplete embryonic development. The symptoms are usually vague. Even though most of these cysts are not cancerous, they are usually removed because there’s a 30%-43% chance they could turn into cancer.

FAQs

  1. What is the recommended treatment for hindgut cysts and why?
  2. How was the multicystic pararectal lesion in the patient treated?
  3. What is the risk of malignancy in hindgut cysts?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tumor resection is to follow the post-operative care instructions carefully. This may include recommendations for rest, wound care, pain management, and follow-up appointments. It is important to adhere to these instructions to ensure proper healing and reduce the risk of complications. Additionally, the doctor may advise the patient on lifestyle changes or monitoring for any signs of recurrence. Regular follow-up appointments and imaging tests may also be recommended to monitor for any potential issues.

Suitable For

Patients who are typically recommended tumor resection are those with hindgut cysts, especially if they present with recurrent pelvic pain, symptoms that progress post partum, and a multicystic pararectal lesion on imaging studies. While most hindgut cysts are benign, there is a significant risk of malignancy, making resection a recommended treatment option. Physiology testing and assessment of nerve integrity may also be conducted preoperatively to ensure optimal outcomes. Robotic-assisted surgery, such as the Da Vinci Xi system, may be utilized for the resection of these lesions.

Timeline

  • Patient experiences pelvic pain that progresses post partum
  • Patient undergoes ultrasound and CT scan, which reveals a multicystic pararectal lesion
  • Physiology conducted to establish preoperative function and pudendal nerve integrity
  • Lesion resected using Da Vinci Xi robotic system
  • Patient recovers uneventfully with complete resolution of symptoms

After tumor resection:

  • Patient may experience some pain and discomfort post-operatively
  • Patient will be closely monitored for any signs of infection or complications
  • Patient will undergo follow-up imaging and tests to ensure complete removal of the tumor
  • Patient may be referred to a medical oncologist for further treatment if the tumor is found to be malignant
  • Patient will be advised on post-operative care and follow-up appointments to monitor for any recurrence

What to Ask Your Doctor

  1. What are the risks and benefits of tumor resection surgery in my case?
  2. What is the expected recovery time after the surgery?
  3. Will there be any long-term effects or complications from the surgery?
  4. How will the surgery be performed (e.g. robotic system, traditional surgery)?
  5. Will I need any additional treatments or follow-up care after the surgery?
  6. How likely is it that the tumor is malignant?
  7. What is the success rate of this type of surgery for my specific type of tumor?
  8. Are there any alternative treatment options available for my condition?
  9. How experienced are you in performing tumor resection surgeries?
  10. Can you explain the potential impact of the tumor on my overall health and quality of life if it is not removed?

Reference

Authors: Roy SP, Khalessi A, Phan-Thien KC. Journal: BMJ Case Rep. 2019 Sep 11;12(9):e231286. doi: 10.1136/bcr-2019-231286. PMID: 31511270