title: Congenital tumors of the retrorectal space in the adult: report of two cases and review of the literature.
abstract: 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.
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Coco
authors.forename: Alberto
authors.initials: A
authors.lastname: Manno
authors.forename: Claudio
authors.initials: C
authors.lastname: Mattana
authors.forename: Alessandro
authors.initials: A
authors.lastname: Verbo
authors.forename: Daniel
authors.initials: D
authors.lastname: Sermoneta
authors.forename: Gianluca
authors.initials: G
authors.lastname: Franceschini
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Gaetano
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Larocca
authors.forename: Luigi
authors.initials: L
authors.lastname: Petito
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pedretti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rizzo
authors.forename: Claudio
authors.initials: C
authors.lastname: Lodoli
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Ugo
mesh_terms: 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