Retrorectal epidermoid cyst--a rare entity: the effectiveness of a transperineal posterior approach.
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 x 52 x 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.


CONCLUSIONS
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.
Sciaudone
G
G
I Division of General Surgery, Second University of Naples.
Di Stazio
C
C
Guadagni
I
I
Pellino
G
G
De Rosa
M
M
Selvaggi
F
F
D000328:Adult; D003937:Diagnosis, Differential; D004814:Epidermal Cyst / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010502:Perineum / Q000601:surgery*; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods*