The sacral lymph nodes lie in front of the sacrum along the median and lateral sacral vessels. They drain the back wall of the pelvis and the posterior parts of the pelvic organs, especially the rectum.
| Location | Anterior surface of the sacrum, along the median and lateral sacral vessels |
|---|---|
| Receives lymph from |
|
| Lymphatic drainage |
Filter lymph from the posterior pelvis and rectum.
Presacral nodes can be involved by rectal and cervical cancers and are included in radiotherapy fields for rectal cancer. Bulky presacral disease may press on the sacral nerve roots and cause sciatic-type pain. They lie behind the mesorectal fascia, outside the standard total mesorectal excision plane.
Spread of rectal or cervical cancer to the sacral nodes in front of the sacrum.
Pain and weakness in the leg from malignant presacral nodes compressing sacral nerve roots.
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