**3.2 Associated anomalies**

Associated congenital malformations are observed in 12–15% of cases and occur more frequently with presacral tumors. The incidence of various congenital malformations associated with SCT ranges from 5 to 26%. Of these, anorectal and genital malformations are most commonly. A growing SCT during the first weeks of embryonic life will encroach between the layers of the cloacal membrane and prevent descent and fusion of the urorectal septum to the cloacal membrane, resulting in a high anorectal malformation with a rectourethral or rectovestibular fistula. The presence of SCT in the same period of time (47th weeks), when cloaca is subdivided by the urorectal septum to form the anorectal canal and the primitive urogenital sinus, could prevent fusion of the genital folds, resulting in a bifid scrotum or hypospadias. The most commonly observed anorectal defects are: imperforate anus, anorectal stenosis and common vertebral anomalies are: sacral hemivertebrae, absence of the sacrum and coccyx [6].

Other associated anomalies include spinal dysraphism, sacral agenesis, dislocation of the hips and meningocele. Rarely, gastrointestinal or cardiac defects are associated with SCT.

Currarino triad represents association of anorectal malformation, sacral dysplasia and presacral mass. Delay in diagnosis of the presacral lesion is common because a rectal examination may not be possible in many cases with anorectal stenosis. Presenting symptoms in some of these unusual cases include perirectal abscess or fistula in ano (**Figure 1**).
