Annals of Coloproctology

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Original Article

Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults: Sung Wook Baek, Haeng Ji Kang, Ji Yong Yoon, Do Youn Whang, Duk Hoon Park, Seo Gue Yoon, Hyun Sik Kim, Jong Kyun Lee, Jung Dal Lee, Kwang Yun Kim; J Korean Soc Coloproctol. 2011;27(6):303-314. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.303

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Purpose

A retrorectal developmental cyst (tailgut cyst, epidermoid cyst, dermoid cyst, teratoma, and duplication) is very rare disease, and the symptoms are not characteristic so that sometimes this disease is still misdiagnosed as a supralevator abscess or a complex anal fistula. We would like to present a clinical approach to this disease.

Methods

We retrospectively examined the charts of 15 patients who were treated for retrorectal cysts from January 2001 to November 2009.

Results

All 15 patients were female. The average age was 41 years (range, 21 to 60 years). Fourteen patients (93.3%) were symptomatic, and the most common symptom was anal pain or discomfort. Nine patients (60%) had more than one previous operation (range, 1 to 9 times) for a supralevator abscess, an anal fistula, etc. In 12 patients (80%), the diagnosis could be made by using the medical history and physical examination. Thirteen cysts (80%) were excised completely through the posterior approach. The average diameter of the cysts was 4.8 cm (range, 2 to 10 cm). Pathologic diagnoses were 8 tailgut cysts (53.3%), 5 epidermoid cysts (33.3%) and 2 dermoid cysts (13.3%). The average follow-up period was 18.3 months (range, 1 to 64 months).

Conclusion

In our experience, high suspicion and physical examination are the most important diagnostic methods. If a female patient has a history of multiple perianal operations, a retrorectal bulging soft mass, a posterior anal dimple, and no conventional creamy foul odorous pus in drainage, the possibility of a retrorectal developmental cyst must be considered.

Citations

Citations to this article as recorded by

Clinical characteristics of presacral cysts and risk factors for long-term fecal incontinence following laparoscopic resection of lesions
Zi-Yan Wang, Pei-Pei Wang, Kai-Wen Xu, Qian-Yu Wang, Jiao-Lin Zhou, Hui-Zhong Qiu, Chen Lin, Bin Wu
Surgery.2025; 187: 109660. CrossRef
Pararectal Epidermal Inclusion Cyst in a Pediatric Patient
Nour H Moosa, Hadeel Bozieh, Nermin Darawi, Fatima Hajjaj, Noor Awad, Firas Almasaid
Cureus.2024;[Epub] CrossRef
Endoscopic Resection of Tailgut Cyst
Oleksandr Kiosov, Vladyslav Tkachov, Sergii Gulevskyi, Yoshifumi Nakayama
Case Reports in Gastrointestinal Medicine.2024;[Epub] CrossRef
Presacral Keratinous and Dermoid Cyst Masquerading as Meningocele – A Rare Case Report
Lucky Gupta
African Journal of Paediatric Surgery.2024; 21(4): 271. CrossRef
A report of presacral epidermoid cyst in perimenopausal women: An extremely rare site and an unusual cause of chronic constipation
Salem M. Tos, Afnan W.M. Jobran, Anas Alasafrah, Izzeddin Bakri, Fahmi Jubran
International Journal of Surgery Case Reports.2023; 103: 107880. CrossRef
Retrorectal epidermoid mistaken for perirectal swelling: A case report
Mossaab Ghannouchi, Mohamed Ben Khalifa, Olfa Zoukar, Karim Nacef, Amina Chakka, Moez Boudokhan
International Journal of Surgery Case Reports.2022; 95: 107187. CrossRef
Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report
Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang
World Journal of Clinical Cases.2022; 10(30): 11139. CrossRef
Chinese expert consensus on standardized treatment for presacral cysts
Gangcheng Wang, Chengli Miao
Gastroenterology Report.2022;[Epub] CrossRef
Presacral epidermoid cyst in a pediatric patient
Lilly Gu, Cara L. Berkowitz, John D. Stratigis, Lee K. Collins, Maria Mostyka, Nitsana A. Spigland
Journal of Pediatric Surgery Case Reports.2021; 71: 101904. CrossRef
Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review
Aikaterini Mastoraki, Ilias Giannakodimos, Karmia Panagiotou, Maximos Frountzas, Dimosthenis Chrysikos, Stylianos Kykalos, Georgios E. Theodoropoulos, Dimitrios Schizas
International Journal of Clinical Practice.2021;[Epub] CrossRef
Successful excision of a retrorectal cyst through trans-sacral approach: A case report
Tlal Matouq Alsofyani, Mohammed Yousef Aldossary, Faisal Fahd AlQahtani, Khalid Sabr, Ameera Balhareth
International Journal of Surgery Case Reports.2020; 71: 307. CrossRef
Anal Gland/Duct Cyst: A Case Report
Guh Jung Seo, Ju Heon Seo, Kyung Jin Cho, Hyung-Suk Cho
Annals of Coloproctology.2020; 36(3): 204. CrossRef
Retrorectal Epidermal Inclusion Cyst: An Incidental Finding During Cesarean Section
Sundus Nasim, Sohail Kumar, Dua Azim, Lajpat Rai, Summaya Saeed
Cureus.2020;[Epub] CrossRef
Combined laparoscopic and perineal approach for the management of recurrent tailgut cyst
Ankur Patel, Pranav Mandovra, Tanveer Majeed, Roy V Patankar
Asian Journal of Endoscopic Surgery.2019; 12(2): 181. CrossRef
Laparoscopic management of epidermoid cyst in an unusual location
Sindhuja Kesavan, Ramakrishnan Parthasarathi, Prakhar Gupta, Chinnusamy Palanivelu
BMJ Case Reports.2019; 12(2): e228043. CrossRef
Tailgut cyst: report of three cases and review of the literature
Ann-Sophie Hufkens, Peter Cools, Paul Leyman
Acta Chirurgica Belgica.2019; 119(2): 110. CrossRef
Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature
K. Nicoll, C. Bartrop, S. Walsh, R. Foster, G. Duncan, C. Payne, C. Carden
Colorectal Disease.2019; 21(8): 869. CrossRef
Laparoscopic surgical management of a mature presacral teratoma: a case report
Liming Wang, Yasumitsu Hirano, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Shintaro Ishikawa, Takuhisa Okada, Nao Obara, Shigeki Yamaguchi
Surgical Case Reports.2019;[Epub] CrossRef
Pre-sacral (retrorectal) abnormal tissue and tumours may be described by a new classification – A review article
Mohammad Bukhetan Alharbi
International Journal of Surgery Open.2018; 11: 1. CrossRef
Precoccygeal epidermoid cyst in a child — A unique case report
J.S. Aihole, G. Aruna, J. Deepak, S. Supriya
African Journal of Urology.2018; 24(4): 336. CrossRef
A Complicated Case of Pregnancy Involving a Presacral Epidermoid Cyst
Daisuke Shigemi, Seiryu Kamoi, Akihisa Matsuda, Toshiyuki Takeshita
Journal of Nippon Medical School.2017; 84(2): 100. CrossRef
Presacral Noncommunicating Enteric Duplication Cyst
Shabnam Seydafkan, David Shibata, Julian Sanchez, Nam D. Tran, Marino Leon, Domenico Coppola
Cancer Control.2016; 23(2): 170. CrossRef

Case Reports

Perineal Reconstructive Surgery of a Cloaca-Like Perineal Defect: A Case Report.: Kye, Bong Hyeon , Kim, Hyung Jin , Lee, In Kyu , Kim, Do Hyoung , Won, Dae Youn , Kang, Won Kyung , Oh, Seong Taek; J Korean Soc Coloproctol. 2009;25(6):441-444.; DOI: https://doi.org/10.3393/jksc.2009.25.6.441

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9 Download
3 Citations

Abstract PDF

Retrorectal or presacral tumors are rare, with incidences of approximately 0.01%. Generally, these tumors have no specific symptoms and are likely to be found incidentally on CT or MRI scans. Most of them are benign masses, but malignant masses are reported on occasion. The modality of treatment is a resection in cases of a benign mass, but chemotherapy or radiation therapy can be done in cases of malignancy. Like our case, a matured cystic teratoma in the retrorectal area is very rare. In addition, no laparoscopic resection of a retrorecal teratoma was reported until 2008. Thus, we report the case of a 31-yr-old female patient who underwent a total laparoscopic excision for a matured cystic teratoma in the retrorectal space.

Citations

Citations to this article as recorded by

Laparoscopic Approach to Type IV Sacrococcygeal Teratoma in an Adult
Mehul V. Sukhadiya, Ushashree Das
Indian Journal of Surgery.2015; 77(S1): 62. CrossRef
Clinicopathological features of retrorectal tumors in adults: 9 years of experience in a single institution
Bong-Hyeon Kye, Hyung-Jin Kim, Hyeon-Min Cho, Hyung-Min Chin, Jun-Gi Kim
Journal of the Korean Surgical Society.2011; 81(2): 122. CrossRef
Multiple Presacral Teratomas in an 18-year-old Girl: A Case Report
Young Jin Park
Journal of the Korean Society of Coloproctology.2011; 27(2): 90. CrossRef

Clinicopathological Features of Retrorectal Tumors in an Adult: A Case Report and Review of the Literatures.: Kwon, Hye Youn , Hur, Hyuk , Min, Byung Soh , Kim, Nam Kyu , Sohn, Seung Kook , Cho, Chang Hwan; J Korean Soc Coloproctol. 2008;24(4):292-297.; DOI: https://doi.org/10.3393/jksc.2008.24.4.292

2,668 View
17 Download
3 Citations

Abstract PDF

Retrorectal tumors are particularly rare among the adult population, occurring in 1 of 40,000 hospital admissions. Clinical diagnosis is difficult and is often delayed because of vague symptoms. This study aimed to investigate the clinicopathological features of retrorectal tumors. Between January 1999 and March 2005, 10 patients were diagnosed with retrorectal tumors at the Department of Surgery, Yonsei University Medical Center, and their medical records were reviewed. We analyzed chief complaints, imaging studies, surgical approaches and pathologic examinations. Out of 10 patients, 8 were female and 2 were male. The mean age was 42.8 years. Four patients had no symptoms. Perianal and abdominal pain were the most common presentations. CT and MRI were the most frequently performed imaging studies. Surgery was performed in 9 patients. Postoperative pathologic diagnosis was possible in 9 patients. An epidermal cyst was the most common tumor (4 patients); others included a mature teratoma, an adenocarcinoma from a tail gut cyst, a duplication cyst, a neurogenic tumor, and a smooth muscle cell tumor. Imaging techniques like CT scans, MRI and TRUS are helpful to determine the size and the extent of a tumor and its relationship to the surrounding anatomical structures for the operative approach. A surgical resection is the standard of treatment and demonstrates good results and a good prognosis.

Citations

Citations to this article as recorded by

Retrorectal Tumors in Adults: A 10-Year Retrospective Study
Abdullah Oguz, Abdullah Böyük, Ahmet Turkoglu, Cemil Goya, Ulas Alabalık, Fatma Teke, Hıdır Budak, Metehan Gumuş
International Surgery.2015; 100(7-8): 1177. CrossRef
Clinicopathological features of retrorectal tumors in adults: 9 years of experience in a single institution
Bong-Hyeon Kye, Hyung-Jin Kim, Hyeon-Min Cho, Hyung-Min Chin, Jun-Gi Kim
Journal of the Korean Surgical Society.2011; 81(2): 122. CrossRef
Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults
Sung Wook Baek, Haeng Ji Kang, Ji Yong Yoon, Do Youn Whang, Duk Hoon Park, Seo Gue Yoon, Hyun Sik Kim, Jong Kyun Lee, Jung Dal Lee, Kwang Yun Kim
Journal of the Korean Society of Coloproctology.2011; 27(6): 303. CrossRef

A Retrorectal Neurofibroma Resected by Transsacral Approach.: Cho, Bu Goan , Ahn, Byung Kwon , Lee, Seung Hyun , Baek, Sung Uhn , Chang, Hee Kyung; J Korean Soc Coloproctol. 2006;22(6):432-435.

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6 Download

Abstract PDF: Tumors in the retrorectal area are rare. Surgical approaches to retrorectal tumors include posterior, anterior, or combined approaches. We have encountered a case of a 56- year-old woman with a retrorectal tumor. She had a solid tumor, 3 cm in size, in the posterior midline rectum 7 cm above the anal verge. The tumor was successfully resected by using a posterior (transsacral) approach with a partial sacrectomy and was diagnosed as being a neurofibroma. There were no postoperative complications.

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