Retrorectal cyst: proteus in the backyard—case series and literature review

Abstract

Retrorectal cysts are cystic lesions located in the retrorectal space and are a distinct subset of retrorectal tumours, which are often misdiagnosed due to their rarity and mimicry of symptoms caused by common diseases. We have described the presentation and management of four patients who were diagnosed with retrorectal cysts from a 10-year retrospective chart review at our institute, a tertiary care centre. In middle-aged women, the following should raise suspicion of retrorectal cyst: gastrointestinal or urinary obstructive features, mass or fullness palpable on the posterior wall on digital rectal examination, presacral dimple, perianal fistula and/or recurrent disease. Such features should prompt an MRI evaluation of the pelvis for definitive diagnosis.

Retrorectal Cysts and Tumors: From Clinical Presentations and Imaging Techniques to Pathological Diagnoses and Management: A case series and literature review

“…A similar female preponderance was reported in the literature for retrorectal cysts and tumors. In a similar case series study, Ramalingam et al observed 4 patients with retrorectal cysts and found out that all of the patients were female (1). In the present study, patients visited the hospital with chief complaints of abdominal pain, pelvic pain, or anal pain.…”

“…Histologically, these cysts can be lined by squamous, columnar, cuboidal, or transitional epithelium because they arise from the endoderm of the primitive gut. Two layers of muscles with myenteric nerve plexus can also be in the cyst's wall (1). Considering the anatomical location of duplication cysts, they may cause bowel obstruction, intussusception, volvulus or hemorrhage, or perforation because of gastric mucosa contents inside.…”

“…Contrary to retrorectal tumors, which are frequently observed in pediatric populations, retrorectal cysts are more prevalent in adults. Retrorectal cysts are rare lesions with an estimated incidence of 2 to 6 patients annually in tertiary care centers (1), and it is essential to note that most patients fall within the age range of 30 to 60 years old. Women tend to experience the condition more frequently than men, with the likelihood of occurrence being three to five times higher among females (2).…”