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A 42-year-old woman presented with a feeling of rectal fullness. On rectal exam there was a large, smooth mass to the right side of the rectum. Proctoscopic exam showed intact mucosa. MRI showed a large lobulated mass in the low pre-sacral space The patient had no neurological symptoms.
The lesion appeared to arise from the fourth right sacral foramen which was markedly enlarged. The clinical diagnosis was neural tumor arising from the fourth sacral nerve root.
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