Abstract
Preoperative biopsy of solid or heterogeneous presacral tumors is safe with various image-guided approaches to percutaneously access the presacral space. Biopsies are most commonly performed via a parasacral or transperineal approach. It is complementary to high-resolution cross-sectional imaging and has a higher concordance with post-operative pathology than imaging alone. This allows for more complete treatment planning with the consideration of various neoadjuvant therapies for tumors that are malignant and for consideration of function-sparing resection for those tumors that are benign.
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