A CASE OF ADULT PRESACRAL EPIDERMOID CYST

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 59; no. 4; pp. 1150 - 1153
• Main Authors: FUJITA, Tomoyuki, NAKAO, Kazuyasu, NAKAHARA, Masaaki, OGINO, Nobuo, YAMANISHI, Hiroshi, TSUJIMOTO, Masahiko
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 1998
• Subjects: adult; epidermoid cyst
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.59.1150

A case of presacral epidermoid cyst successfully resected via sacral approach in a 50-year-old woman is reported. The patient was seen at the hospital because of lower abdominal pain in May, 1996. The previous medical history revealed that she underwent laparotomy and drainage for retropelvic abscess at elsewhere in October, 1993, when she also complained of fever and lower abdominal pain. After admission a smooth, soft and unmovable tumor was palpatd right behind the rectum by digital examination. CT, MRI and ultrasonographic examination showed a presacral cystic tumor, 12×10×8cm in size. Aspiration biopsy cytology of the tumor showed squamous cells, suggesting presarcal teratoma. The tumor was resected by using a sacral approach with Jack-knife position. Histologically, the inside of the cyst wall consisted of keratinizd squamous epithelium nd in part mucin producing columnal epithelium. No sebaceus gland and hair was found. The cyst was diagnosed as epidermoid cyst. In a review of Japanese literature, eight cases of adult presacral epidermoid cyst were seen. All the patients were female. Six patients of them were asymptomatic and detected to have the lesion at a medical checkup, and five patients were operated on via sacral approach.