Rare – Pelvic tumor (sarcoma) in contact with sphincter, vagina and pelvic floor muscles
History
A 32-year-old female patient in whom a large pelvic tumor (left side) was discovered during labor because it was impossible to give birth normally due to the pressure of the tumor on the vagina. The exit of the fetus was done through caesarean section.
After delivery, an MRI was performed which revealed a lobular mass measuring 10 cm occupying the left side of the pelvis at the level of the pelvic floor with intense angiography in contact with the internal thyroid muscle, the vagina and the anus (sphincter and levator).
As the patient reported, she felt heaviness and discomfort in the left pelvis (area of the tumor) both during sexual intercourse and during prolonged standing or walking for several months, but nothing has been found during pregnancy. These symptoms subsided after the operation.
Surgical Treatment
The operation was performed with transabdominal and transanal access. The upper part of the tumor was mobilized from the abdominal area and the lower part from the rectal area outside the sphincter. Detachment of the tumor from the vagina, rectum and sphincter and pelvic muscles was performed without affecting the patient's functionality postoperatively. The tumor's blood supply came from the pelvic muscles and was strongly attached to them.
Re-examination with MRI 3 months after the operation shows the elimination of the tumor and the very good recovery of the area. The patient has normal bowel function and symptoms have disappeared from the vagina and left lower extremity (leg).
Clinic of Intestinal and Anal Diseases
Operations of this type are highly specialized and are performed in very few centers internationally. The Intestinal and Anal Diseases Clinic comes to meet this very need for specialized surgical techniques for the intestine and anus in Greece.