Retrorectal/Presacral Epidermoid Cyst: Report of A Case

Abstract

Although epidermal cysts are frequently observed throughout the body, they are rarely found in the retrorectal/presacral regions. Retrorectal epidermal cysts are congenital lesions of ectodermal origin and generally occur in women during the reproductive period. In this case report, a 47 year old female patient with 25 years of complaint of a mass extending from the perianal region to the retro-coccygeal region is discussed. A total mass excision with paracoccygeal incision was performed under spinal anesthesia. The histopathologic examination demonstrated an epidermal cyst. Correct diagnosis and appropriate treatment when first detected significantly decrease the recurrence and complication risks in all retrorectal tumors. Any mass should be completely removed in the treatment.

Giant Retrorectal Epidermoid Cyst Masquerading as a Perianal Swelling

“…Due to late clinical presentation of the cyst, complications may occur, which include infections and bleeding; however, the epidermoid cysts are unlikely to undergo malignant transformation [6]. Epidermoid cysts may be misdiagnosed with anorectal abscess, complicated fistula, and pilonidal sinuses [3]. In our case, the woman presented with perianal abscess, and surgical drainage was performed initially.…”

“…The common presentation is related to the mass effect of the cyst. Most of the late presentations are because of the misdiagnosis with other presacral cysts such as tailgut, dermoid, and teratomas [3]. Complications associated with retrorectal cysts include perianal abscess, perineal fistula, rectal fistula, and bleeding in the rectum [4].…”

Laparoscopic management of epidermoid cyst in an unusual location

“…Pararectal epidermoid cysts occur more commonly in females with infrequent occurrence in males 9. Most of the patients, 26%–50%, are asymptomatic, and diagnosis is made incidentally during imaging 10. Symptoms vary according to the size of the lesion, location, presence of infection or malignancy.…”

A Rare Case of Presacral Epidermoid Cyst in an Adult Male: Emphasis on Diffusion Weighted Magnetic Resonance Sequences in Preoperative Imaging

“…Therefore, correct diagnosis and proper treatment for a presacral lesion is very important as inadequate primary surgery can lead to increased morbidity. It can also increase the risk of recurrence and can even cause complications such as fecal incontinence [ 4 ].…”

“…The exact incidence of presacral epidermoids is unknown; however, a previous report suggests that they are responsible for one in 40,000 admissions [ 3 ]. The lesions can slowly grow over time and become infected and inflamed [ 4 ]. On histologic examination, these cysts have a thin wall lined by stratified squamous epithelium with a distinct granular cell layer, surrounding a mixture of desquamated debris, cholesterol, keratin, and water [ 1 ].…”