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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2009 April;168(2):115-118
Anterior sacral meningocele: two clinical cases
Croce P., Perotti D., Frigoli A.
Divisione di Ginecologia e Ostetricia del Civico Ospedale di Cotogno, Lodi, Italia
Anterior sacral meningocele (ASM) is a rare congenital anomaly; about 300 cases have been reported, some of which occurring within the same family. Classified as an occult spinal dysraphism, ASM is caused by herniation of the dural sac of the pelvic region due to a congenital defect of the sacrum. Two cases are presented: the one concerns a young woman, asymptomatic, in whom a pelvic mass and a uterine deformation were initially diagnosed at routine gynecologic examination. Subsequent exploration laparoscopy and magnetic resonance imaging (MRI) studies showed ASM associated with a double uterus. The other case is that of the patient’s mother discovered to have ASM after it was diagnosed in her daughter. ASM presents as a uni- or multiloculated cystic mass in the pelvic or retroperitoneal regions occasionally associated with retroperitoneal benign tumors. Common symptoms include pelvic pain, menstrual pain, bladder dysfunction, intestinal dysfunction, sensory disturbance of the perineum and the lower limbs. ASM may also be asymptomatic. Because of its location and appearance, ASM may be mistaken for an ovarian cyst for which patients seek gynaecologic advice. These cases are presented to call attention to a rare condition which, if misdiagnosed, may be inadequately assessed and consequently improperly treated.