Presentation
Difficult defecation.
Patient Data
IV and rectal contrast were given.
There is a well-defined large presacral soft tissue mass lesion, measures about 10 x 10 x 12 cm, with a central hypodense area (necrosis), causing mass-effect upon the rectum and urinary bladder pushing them anteriorly, and shows heterogenous avid enhancement with adjacent neovascularization (highly vascular lesion).
No evidence of internal calcification or fat component on precontract scan.
Few bilateral small cortical renal cysts are noted.
Case Discussion
Features are suggestive of presacral solitary fibrous tumor (SFT), which was confirmed by Tru-cut biopsy.
However, for other differential diagnoses of presacral lesions, you can see this article "widening of the presacral space (differential)".
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