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Session: ePoster: Other Neoplasia and Endoscopy 1 (Sun8)

EP313 - Case of Young Male With Presacral Neuroendocrine Tumor Arising in the Background of a Sacrococcygeal Teratoma

Sunday, May 11, 2025
8:21 AM – 8:26 AM PT
Location: Monitor 7, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Mercedes D. Nikzad, MD

    Colon and Rectal Surgery Fellow
    Henry Ford Hospital
    Grosse Pointe Woods, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • HP

    Hakmin Park, MD

    Attending Radiologist
    Henry Ford Hospital
    Detroit, Michigan, United States

    Disclosure information not submitted.

  • KA

    Khaleel Al-Obaidy, MD

    Pathologist
    Henry Ford Hospital
    Detroit, Michigan, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • MA

    Megumi Asai, MD

    Senior Staff
    Henry Ford Health
    Detroit, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Mercedes D. Nikzad, MD: This individual has no financial relationships with ineligible companies.
Megumi Asai, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Tumors of the presacral space are uncommon regardless of the etiology. Among those, neuroendocrine tumor (NET) is exceedingly rare, and less than 100 cases have been reported in the past. The mainstay of treatment of presacral NET is surgical resection, however, proper management and outcomes are not well established. This report describes a rare case of an adult patient with a presacral NET arising in the background of a mature cystic teratoma.

Methods/Interventions: A 30-year-old male was found to have a 2 cm cystic lesion in between the rectum and distal sacrum on a CT abdomen/pelvis that was obtained during workup for thrombocytopenia. MRI pelvis again demonstrated the presacral cystic lesion with a sub-centimeter focus of mural nodular enhancement. Flexible sigmoidoscopy noted no abnormality in the sigmoid colon and rectum. He subsequently underwent excision of the lesion with coccygectomy via a posterior approach.

Results/Outcomes: The surgical pathology was consistent with a well-differentiated NET arising with a background of sacrococcygeal mature cystic teratoma. Post-operative DOTATATE PET scan 6 weeks and 6 months after the surgery did not identify residual, recurrent or metastatic disease.

Conclusion/Discussion: Presacral NETs are a rare disease. Previous reports suggested that most of them are well-differentiated and locally involved, however, distant metastasis may occur.  Although there is currently no standardized treatment algorithm, this case and other reports demonstrate that presacral NET can be managed with surgical resection when locally limited. More information is needed about surveillance and prognosis, especially in relation to neuroendocrine-specific treatment.