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June 28, 2026The American Surgeon

Atypical Presentation of Metastatic Prostate Adenocarcinoma in the Presacral Space: A Case Report of Diagnostic Resection via the Kraske Approach

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Authors

ATAlex TranSRSowsan Rasheid

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Overview

Case report demonstrates unexpected metastatic prostate adenocarcinoma diagnosis in a 69-year-old man after resection of presacral mass, indicating further diagnostic protocols.

Key Points

  • This case aims to highlight the rarity and diagnostic challenges of metastatic prostate adenocarcinoma in the presacral space.
  • A 69-year-old man underwent resection of a presacral mass via the Kraske approach due to suspected primary neoplasm.
  • Preoperative assessments included MRI, which suggested a neurogenic tumor, and omitted serum PSA measurements and biopsy due to location hazards.
  • Histopathological analysis confirmed metastatic prostate adenocarcinoma post-resection.
  • Histopathology revealed metastatic prostatic adenocarcinoma with positive immunostaining for PSA and prostatic acid phosphatase.
  • Had the primary prostate tumor been identified preoperatively, management would have significantly changed.
  • The Kraske approach provided adequate exposure for resection, emphasizing its utility in suspected presacral neoplasms.

Cite This Study

Tran et al. (2026) studied this question.

synapsesocial.com/papers/6a40bae361bb0a67205c6a4dhttps://doi.org/10.1177/00031348261465399
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Also Consider

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  1. 1Presacral Schwannoma Resembling Lymph Node Metastasis in a Patient with Locally Advanced Prostate Cancer2024
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  4. 4Presacral tumor, experience of two cases in Mexico and review of the literature2024
  5. 5Infiltrating Presacral Neuroendocrine Tumor: An Atypical Cause of Lower Gastrointestinal Bleeding2026