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Mr. M. is an 80-year-old African American male with a long-standing history of low-back pain, urinary incontinence, and intermittent stool incontinence following external beam radiation for treatment of stage T1C prostate cancer. Additional medical history includes hypertension and diabetes with existing peripheral neuropathy. He developed progressive low-back pain with radiation to the right buttocks and posterior thigh. A CT of the pelvis revealed an S3 sacral meningocele, extending anteriorly, inferiorly, and posteriorly, with the largest dimensions being approximately 10.2 × 11.0 cm. He underwent laparoscopic loop colostomy followed by resection of the meningocele. Pathology demonstrated a pooly differentiated adenocarcinoma consistent with a rectosigmoid primary, with tumor present at the distal surgical margins.

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