Removal of giant presacral neurogenic tumors with application of the customized 3D-printed models: case series analysis and literature review

Abstract

The characteristics and principles of surgical treatment of giant presacral neurogenic tumors are analyzed on the example of authors’ own series of cases and based on the literature review. Three clinical cases of surgical treatment of patients with giant presacral neuromas are presented. Besides routine preoperative clinical examination, 3D-printed models of pelvic bones, tumors and blood vessels were made based on CT-angiography data. In two cases, giant L5 root neuromas with presacral extension were removed through retroperitoneal approach, and in one case, two-stage removal of the giant presacral neurofibroma through the median laparotomic and dorsal approaches was performed. Giant presacral neurogenic tumors are the rare pathology in the practice of spinal surgeons. Surgical treatment should be carried out by a multidisciplinary surgical team. It should be borne in mind that life-threatening complications are common in the early postoperative period. Application of customized 3D-printed models is an additional useful tool of perioperative planning.

Keywords

• schwannoma
• neurofibroma
• retroperitoneal tumor
• presacral tumor
• spine
• 3d model