Introduction: Pilonidal sinus is an extremely common disease in adolescents and young people; the report aims to present a new minimal invasive technique for the treatment of the pilonidal sinus. Case presentation: A 14-year-old female presented in the emergency department with a pilonidal sinus discharging lesion for a 6-month duration. There was a local redness with multiple fistulas discharging purulent content. The lesion was drained and after 3 months the patient was referred to the operation room for the lesion excision using the Pediatric Endoscopic Pilonidal Sinus Treatment under sedation. After 2 months of follow up the patient remains asymptomatic. Conclusion: Pilonidal sinus is a common disease in adolescents and young people. Pediatric Endoscopic Pilonidal Sinus Treatment seems to be an effective treatment strategy with cosmetic results and painless postoperative period.

Two cases of perineal polypoid-like lesions in children are described. The first patient is a 21 months old girl with a congenital perianal pedunculated asymptomatic lesion, covered by normal skin, not increased in size since birth (Figure 1). A MRI showed a lesion localized at right side of median raphe, in contact with external anal sphincter, without any apparently fistula and no dystrophy of raphe or sacrum (Figure 2). A surgical resection was performed. Histological examination revealed a soft fibroma. Post-operative period did not presented complications or recurrence. The second patient is a 7 months old girl derived to Pediatric Surgery Department of Verona Hospital for the presence of a mass localized in the left labium majus (Figure 3). The lesion was soft, pedunculated, asymptomatic and it has been increased in size since birth.