{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:16:32Z","timestamp":1767665792667},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,11,3]],"date-time":"2016-11-03T00:00:00Z","timestamp":1478131200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Presacral masses are uncommon and have malignant potential; treatment typically includes surgical excision. However, there are conditions such as extramedullary haematopoiesis (<jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content>) which are benign. The present study aimed to summarize the presentation of presacral <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content> in our institution, to review the literature and to offer management strategies for this rare condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The literature was searched for articles related to presacral <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content>, and case reports were collected from articles meeting the inclusion criteria. We collected data on patient demographics, diagnostic investigation, management and the results of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine patients were included in the systematic review. Initial imaging included computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) or ultrasound (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>) suggestive of <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content>. Some patients then underwent a technetium scan (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>7, 18%), biopsy of the presacral lesion (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>27, 69%) or excision of the entire mass (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>3, 8%). All patients who underwent technetium scan were confirmed to have <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content>, demonstrating enhancement similar to bone marrow. Patients who underwent technetium scan and presacral mass biopsy had concordant results confirming presacral <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>5, 13%). Data on management were available for 35\/39 (90%) with most patients followed by clinical observation (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>20, 51%). Symptomatic patients were treated with radiotherapy (15%), surgical excision (15%) or hydroxyurea (5%) and blood transfusions (10%). Most (81%, <jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>17\/21) patients whose outcome was reported remained asymptomatic or experienced pain relief.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although uncommon, <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content> should be considered in the differential diagnosis of a presacral mass. Presacral <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content> is a benign condition that can be suspected on <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> and confirmed with technetium scan. Patients may not necessarily need to undergo biopsy to confirm haematopoietic elements. Unlike other presacral masses, patients diagnosed with presacral <jats:styled-content style=\"fixed-case\">EMH<\/jats:styled-content> can be managed by observation. If symptomatic, radiotherapy or surgical excision may be offered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13427","type":"journal-article","created":{"date-parts":[[2016,6,22]],"date-time":"2016-06-22T19:58:39Z","timestamp":1466625519000},"page":"1033-1040","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A systematic review of presacral extramedullary haematopoiesis: a diagnosis to be considered for presacral masses"],"prefix":"10.1111","volume":"18","author":[{"given":"P. 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