• dermoid cyst
• epidermoid cyst
• keratinous cyst
• presacral tumour

• Humans
• Dermoid Cyst/diagnosis
• Dermoid Cyst/surgery
• Female
• Diagnosis, Differential
• Infant
• Meningocele/diagnosis
• Meningocele/surgery
• Magnetic Resonance Imaging
• Sacrum/surgery

• epidermal inclusion cyst
• epidermoid cyst
• fistula
• gluteal area
• gluteal region
• pararectal space
• pelvic cavity

• consensus
• pelvic cavity
• presacral cyst
• presacral space
• retrorectal tumors

• Case report
• Epidermoid cyst
• Pelvic mass
• Presacral

Perirectal epidermoid cysts are rare masses arising from the ectodermal germ cell layer of the hindgut and are predominantly found in middle-aged women. It is often difficult to make an accurate diagnosis of these cysts and it is equally challenging to distinguish it from other developmental cysts.

We report the case of an 18-year-old female patient with a perirectal mass who presented to the hospital with constipation. The patient experienced sacrococcygeal falls and burns on the left buttocks during growth. Three-dimensional computed tomography scans indicated abnormal sacral vertebrae with the sacral canal partially enlarged and opened. Pelvic magnetic resonance imaging showed a 55 mm × 40 mm × 35 mm unilocular cystic mass in the perirectal space and a solitary sinus in the left ischiorectal fossa. The cyst was completely resected posteriorly using the sacrococcygeal approach. The pathology was verified to be an epidermoid cyst. The patient remained recurrence-free after 6 mo of follow-up.

Successful treatment of perirectal epidermoid cysts depends on comprehensive evaluation. This is significant for the surgical approach and prognosis.

• Perirectal mass
• Epidermoid cyst
• Surgery
• Anal sinus
• Case report

• Adult
• Cysts/diagnostic imaging
• Cysts/epidemiology
• Female
• Humans
• Laparoscopy
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Young Adult

An epidermal inclusion cyst is a benign lesion, frequently observed throughout the body. However, its presence in the retrorectal region is a rare occurrence. With a higher incidence in women and non-specific symptoms, these cysts are mostly an incidental finding. Here, we report a case of a 33-year-old female presenting with complaints of abdominal pain and sensation of incomplete and painful defecation. The patient’s history revealed that a large pelvic cyst was found incidentally during her first cesarean section (CS) owing to an arrest in labor. A presumptive diagnosis of rectal duplication cyst was made based on digital rectal exam (DRE), computed tomography (CT), and magnetic resonance imaging (MRI) findings. For cyst removal, the patient underwent a midline laparotomy. A postoperative biopsy led to the confirmed diagnosis of the retrorectal epidermal inclusion cyst. On follow-up, our patient showed a smooth recovery without any complications. We conclude that when dealing with a pregnant woman with a pelvic mass, developmental cysts should always be kept in mind. Timely diagnosis and management of a retrorectal mass is essential for effective treatment and to prevent subsequent complications.

• cyst
• epidermoid
• inclusion cyst
• presacral
• retrorectal

•

Retrorectal cysts are rare congenital cystic lesions commonly seen in middle-aged women.

Retrorectal cysts are rare congenital cystic lesions usually diagnosed in middle-aged women. They are generally asymptomatic; however, local pressure may result in complications. Pain or discomfort in the pelvic, sacral, lower back or perianal area are the most common symptoms. The diagnosis is difficult, and multidisciplinary management is required. An epidermoid cyst is the most common type. Surgical resection is the main treatment, and 3 operative approaches are commonly used: abdominal, trans-sacral, and combined abdominosacral. The selection of the approach depends on the nature and location of the lesion. Here, we present a case that demonstrates the trans-sacral approach to a retrorectal cyst is a feasible option in terms of safety and minimal invasiveness for selected patients with this rare type of retrorectal cystic lesion.

A 38-year-old woman with no comorbidities incidentally showed a retrorectal cyst on magnetic resonance imaging performed during pregnancy. The patient underwent surgical resection under general anesthesia, trans-sacral incision was performed, the posterior rectum exposed, and the cyst removed. No complications were seen in the postoperative period.

Posterior trans-sacral resection (Kraske) is preferred for patients with posterior retrorectal cyst because it provides adequate exposure.

Posterior trans-sacral resection allows proximal extension for elimination of the infection and in cases of adherence of the cyst to surrounding structures or in malignancy, which require en bloc resection.

• Posterior trans-sacral resection
• Retrorectal cyst
• Tailgut cyst

Anal gland/duct cyst (AGC) is rare and observed in only 0.05% of patients undergoing anal surgery. AGC is thought to be a retention cyst in the anal gland and arises when an obstruction of the anal duct causes fluid collection in the anal gland. We report a case of AGC in a 66-year-old woman without anal symptoms. Found by colonoscopy, the AGC was excised transanally. The histopathology of the specimen confirmed AGC. Colonoscopists should include AGC in the differential diagnosis of anal canal mass and rule out of malignancy. Excision is recommended for definitive diagnosis and treatment.

• Anal canal
• Anal gland cyst
• Colonoscopy

Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery.

A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas.

Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.

• Laparoscopic
• Mature teratoma
• Retrorectal

• Tailgut Cyst
• cancer
• hamartoma
• malignancy
• retrorectal

• Tailgut cyst
• malignancy
• retro-rectal hamartoma

• Laparoscopy
• recurrent
• tailgut cyst

• gastroenterology
• general surgery

• epidermoid cyst
• pregnancy
• presacral developmental cyst

• Rectal
• cyst
• epidermoid
• perianal
• presacral