Congenital tumors of the retrorectal space in the adult: report of two cases and review of the literature.
OBJECTIVE
To describe and discuss, on the basis of the authors' experience and a review of the literature, the main aspects regarding the etiology, diagnosis, treatment and prognosis of congenital tumors of the retrorectal space.


METHODS
We present 2 cases of congenital retrorectal tumors, a sacrococcygeal teratoma and a dermoid cyst, which represent, from the pathogenetic point of view, the most frequent presentation of the rare tumors of the retrorectal space.


RESULTS
The reported cases are typical. The teratoma presented as an encapsulated, mixed mass located in the pelvic cavity behind the rectum and the vaginal canal, without signs of sacral involvement. The dermoid cyst appeared as a unilocular lesion filled with sebum and hair, which extended laterally to the iliopubic branch, medially to the urethra and anal canal, and posteriorly to the adipose tissue of the right buttock. Pelvic MRI produced a precise picture of the extension of the lesion and of the relationship between the mass and the pelvic organs and surrounding bony structures. Both lesions were completely removed via the perineal approach without coccygectomy. No recurrences were observed at 2 years of follow-up.


CONCLUSIONS
Congenital retrorectal tumors are rare. MRI is crucial for diagnosis and preoperative planning. Complete surgical removal is the treatment of choice. Resection of the coccyx is necessary only in case of its involvement by the neoplastic mass or suspected malignant transformation.
Coco
Claudio
C
Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Manno
Alberto
A
Mattana
Claudio
C
Verbo
Alessandro
A
Sermoneta
Daniel
D
Franceschini
Gianluca
G
De Gaetano
Annamaria
A
Larocca
Luigi Maria
LM
Petito
Luigi
L
Pedretti
Giorgio
G
Rizzo
Gianluca
G
Lodoli
Claudio
C
D'Ugo
Domenico
D
D000328:Adult; D003884:Dermoid Cyst / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D010502:Perineum / Q000601:surgery; D012007:Rectum; D012187:Retroperitoneal Space; D013724:Teratoma / Q000151:congenital / Q000175:diagnosis / Q000601:surgery