Retrorectal Epidermoid Cyst – a Rare Entity: the Effectiveness of a Transperineal Posterior Approach

Abstract

Background: Presacral cysts are rare presacral tumours. The ideal treatment is a matter of debate.

Methods: We report the case of a 39-year-old woman referred to our institution for a presacral mass, casually diagnosed during a pelvic ultrasound examination. Ano-rectal examination and MRI revealed the presence of a mass (53 χ 52 χ 54 mm) in the retrorectal space, located between the right pyriform muscle and the lateral rectal wall, without signs of invasion of the surrounding structures. We performed the intervention with a transperineal approach in the jack-knife position.

Results: Operating time was 20 minutes. During the postoperative period no complication was observed. The patient was discharged in good general condition. No complication occurred during 48 months follow-up. Conclusion: We chose this approach, because, although alternative approaches are described in the literature, they are based on a small number of patients, even if showing encouraging results. We found the posterior procedure safe, feasible and effective.

Key Words:

• Epidermal cyst
• presacral cyst
• retrorectal tumour
• transperineal access.

Additional information

Notes on contributors

F. Selvaggi

F. Selvaggi, M.D., E.B.S.Q. via Francesco Giordani, 42 80122 Naples, Italy Tel.: [phone] Fax: [phone] E-mail: [email protected]