Laparoscopic resection for a relapsed presacral epidermoid cyst penetrating the ischiorectal fossa

Sakurai, Toshinori; Mukai, Toshiki; Kawachi, Hiroshi; Hiyoshi, Yukiharu; Yamaguchi, Takahiro; Nagasaki, Toshiya; Akiyoshi, Takashi; Fukunaga, Yosuke

doi:10.1111/ases.13043

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…No undifferentiated cells were observed, and ectodermal skin structures primarily were seen, as noted in a previously documented dermoid MCT in the male pelvis [2]. The differential diagnosis for a cystic mass in this region includes hydatid cyst [26], epidermoid cyst [27], mycetoma [4], liposarcoma [28], hematoma, sarcoma, and carcinoma. Notably, the literature is inconsistent in the discrimination, or lack thereof, between the often subcutaneous dermoid cysts and dermoid MCTs.…”

Section: Discussionmentioning

confidence: 52%

Primary Retroperitoneal Mature Cystic Teratoma (Dermoid Cyst) in Pelvic Musculature

Fisher,

Ramseyer,

Eriksson

et al. 2024

J Clin Med Surgery

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Dermoid cysts, or mature cystic teratomas containing ectoderm-derived skin adnexa, rarely occur intramuscularly, especially within the male pelvic musculature. We present a male patient with a dermoid cyst within the obturator internus spreading into the adductor compartment and the pelvic cavity. In contrast to dermoid cysts in previous reports, the cyst appeared centered in muscle rather than simply perforating muscle via an extension. The case is also notable for the rapid recurrence of the cyst after incomplete resection and intraoperative rupture

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Section: Discussionmentioning

confidence: 52%

Primary Retroperitoneal Mature Cystic Teratoma (Dermoid Cyst) in Pelvic Musculature

Fisher,

Ramseyer,

Eriksson

et al. 2024

J Clin Med Surgery

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“…The presacral cavity is surrounded anteriorly by the rectum, posteriorly by the sacrum/coccyx, cranially by the peritoneal reflection, and caudally by the anterior sacrococcygeal ligament and coccygeus muscle [ 4 ]. Various tumors arise in the presacral cavity due to the contact with the caudal end of the fetus and the aggregation of numerous fetal tissues, and these have been defined as developmental cysts [ 1 , 6 ]. Developmental cysts are classified as dermoid, epidermoid, and tailgut cyst [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are risks associated with the need for a large wound over 10 cm in size, postoperative anal dysfunction, fistula formation, and sacral nerve disorder [ 8 ]. Previous reports have cited that transsacral incision is a useful method when the tumor is located below S3, near the coccyx, or in the ischiorectal space [ 6 , 9 ]. The laparoscopic transabdominal approach can help recognize the rectum, surrounding blood vessels, and nerves, especially due to a laparoscopic magnifying view with small incisions, whereas other reports suggest that the laparoscopic transabdominal approach is preferable when the tumor is located above S3 and is larger than 8 cm [ 4 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The base of the tumor was attached to the levator ani (c). The levator ani was partially resected with the tumor attached, without injuring the rectum (d) cavity due to the contact with the caudal end of the fetus and the aggregation of numerous fetal tissues, and these have been defined as developmental cysts [1,6]. Developmental cysts are classified as dermoid, epidermoid, and tailgut cyst [1].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic transabdominal approach for resection of presacral epidermoid cyst in an obese man: a case report

Yoshida,

Nakamura,

Shigaki

et al. 2024

surg case rep

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Background Complete resection of presacral epidermoid cysts is recommended due to the potential for infection or malignancy. Transsacral and transabdominal approaches have been used to treat presacral tumors. However, there are no standard surgical approaches to resection. We present the case of a presacral epidermoid cyst in an obese male patient who underwent laparoscopic transabdominal resection. Case presentation A 44-year-old man was referred to our hospital for treatment of a cystic tumor on the pelvic floor. Contrast-enhanced computed tomography revealed a 45 × 40-mm tumor on the left ventral side of the rectum, right side of the ischial spine, dorsal side of the seminal vesicles, and in front of the 5th sacrum. Enhanced magnetic resonance imaging revealed a multilocular cystic tumor with high and low signal intensities on T2-weighted images. The tumor was diagnosed as an epidermoid cyst. We considered the transsacral or laparoscopic approach and decided to perform a laparoscopic-assisted transabdominal resection since the tumor was in front of away from the sacrum, and a transsacral approach would result in a larger scar due to poor visibility from the thickness of the buttocks. The entire tumor was safely resected under laparoscopic guidance, because the laparoscopic transabdominal approach can provide a good and magnified field of view even in a narrow pelvic cavity with small skin incisions, allowing safe resection of the pelvic organs, vessels, and nerves while observing the tumor contour. Conclusions The laparoscopic transabdominal approach is an effective method for treating presacral tumors in obese patients.

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“…However, in a rare case of malignancy, rapid growth and bleeding have also been reported (6). In female patients, epidermal cysts in the perineum may displace the anus and vagina and extend into the pelvic cavity adjacent to the rectum (7). Ultrasound, MRI, and CT can be used as imaging modalities in these patients.…”

Section: Discussionmentioning

confidence: 99%

Management of Perineal Epidermoid Cyst in a 20-year-old Female

Tanoğlu

Çetin

Şevket

et al. 2023

Düzce Tıp Fakültesi Dergisi

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Epidermoid cysts are cutaneous or subcutaneous masses caused by the implantation of epidermal elements into the dermis. This case report presented an epidermal cyst of the perineum clinically mimicking endometriosis in a female patient. A 20-year-old virgo female patient was admitted to our clinic with complaints of severe pain, especially in the right leg, and postmenstrual bleeding for three years. In the transrectal ultrasound, a 54*39 mm cystic lesion with dense internal echo was detected in the medial neighborhood of the pelvic floor right obturator internus muscle. Since the cystic lesion detected in the contrast-enhanced pelvic MRI was evaluated as an epidermoid cyst and no significant endometrioma or endometriosis focus was detected, an operation was planned. Surgical excision should be performed not only for symptom relief and diagnosis but also to exclude rare malignancy. However, it is vital to master the pelvic and perineal anatomy along with careful surgery.

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Laparoscopic resection for a relapsed presacral epidermoid cyst penetrating the ischiorectal fossa

Cited by 3 publications

References 9 publications

Primary Retroperitoneal Mature Cystic Teratoma (Dermoid Cyst) in Pelvic Musculature

Primary Retroperitoneal Mature Cystic Teratoma (Dermoid Cyst) in Pelvic Musculature

Laparoscopic transabdominal approach for resection of presacral epidermoid cyst in an obese man: a case report

Management of Perineal Epidermoid Cyst in a 20-year-old Female

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