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✓ Anterior sacral meningocele was first described in 1837. Most reported cases were associated with complications, including meningitis and death, because of misdiagnosis or inappropriate surgical approach. The authors present a case of anterior sacral meningocele accidentally discovered during pregnancy and provide unique magnetic resonance imaging documentation. The pathogenesis, management, and surgical technique are discussed.

✓ A woman presented with a mass in the left groin, which was later shown to be a sliding hernia. A bony sacral defect prompted investigation, which uncovered a massive anterior sacral meningocele. Examination, including ultrasonography and myelography, is discussed, and a surgical approach proposed.

✓ A patient with an anterior sacral meningocele combined with a hamartoma was diagnosed with x-ray films, myelography, and computerized tomography. She was successfully operated on by a transabdominal approach.

✓ Anterior sacral meningoceles are rare. This report describes familial anterior sacral meningoceles in a father and daughter who underwent magnetic resonance imaging as part of the preoperative evaluation. Magnetic resonance imaging showed a pelvic teratoma in the daughter and confirmed the absence of abnormal tissue in the father — findings not clearly provided by ultrasound studies, myelography, or contrast-enhanced computerized tomography. It is believed that MR imaging is the most useful preoperative diagnostic technique available in establishing a treatment plan for anterior sacral meningocele.

✓ A case of familial anterior sacral meningocele associated with a dermoid tumor is reported. This patient presented with recurrent aseptic meningitis. The role of computerized tomography following metrizamide myelography in the diagnosis of this lesion is discussed.