Extragenital pelvic tumors in women

Abstract

Pelvic tumors of extragenital origin are of interest to the obstetrician, since they occasionally obstruct the birth canal at the time of delivery. These tumors are of interest to the gynecologist, since they present problems in differential diagnosis and surgical management. To the pathologist they present a variety of gross and microscopic pictures rarely encountered in any other tissue. Such tumors often simulate tumors of the ovary and fibroid tumors of the uterus. They may be found to arise from the pelvic bones and their surrounding soft parts, from nerve tissue or from some congenital anomaly. They may be freely movable or adherent to the anterior sacral wall. This paper is a clinical and pathologic study of these tumors.Although the literature contains no comprehensive review of extragenital pelvic tumors in women since Lever's report in 1843,1 there are numerous articles reporting on isolated examples and small series of these tumors. Thus Middeldorpf in 18852 called attention to the presacral group of teratomas arising from the postanal hindgut. Cragin in 18933 emphasized the importance of ectopic pelvic kidneys in the matter of obstructing the birth canal. Utter and Bates4 and Hundling5 focused attention on the neurogenic group of presacral tumors; namely, the neurofibromas, ganglioneuromas and ependymal-cell gliomas. Fletcher, Woltman, and Adson6 found that presacral chordomas as a group were frequently confused with chondromas. Cases of vesical tumors with presacral extension were the subject of a paper by Sheffery7 in 1946, while Banner, Hunt, and Dixon8 observed similar extension of a rectal carcinoma. These and numerous other excellent articles9–22 formed a substantial background for our study of this interesting subject and have made possible a comparison of our own findings with those of others interested in the field.