Bi-lobed Perirectal Epidermoid Cyst: An Unusual Cause of Hematochezia in a Middle-aged Woman

Pararectal Epidermal Inclusion Cyst in a Pediatric Patient

Epidermal inclusion cysts, commonly found cutaneously, rarely manifest in the pelvis. They are typically asymptomatic and often occur following trauma or surgical interventions. Imaging modalities, notably computed tomography (CT) scans and magnetic resonance imaging (MRI), play a crucial diagnostic role. Herein, we report a rare case of a four-year-old female with a complicated medical and surgical history, presented with pain in the right gluteal region in the setting of past history of abscess drainage in the same area. Imaging revealed a cystic lesion in the right pararectal space and a fistula extending between the pelvic cavity and gluteal region. A laparotomy was performed, and a histopathologic examination confirmed the diagnosis of an epidermal inclusion cyst with no evidence of malignancy.

Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report

BACKGROUND

Perirectal epidermoid cysts are rare masses arising from the ectodermal germ cell layer of the hindgut and are predominantly found in middle-aged women. It is often difficult to make an accurate diagnosis of these cysts and it is equally challenging to distinguish it from other developmental cysts.

CASE SUMMARY

We report the case of an 18-year-old female patient with a perirectal mass who presented to the hospital with constipation. The patient experienced sacrococcygeal falls and burns on the left buttocks during growth. Three-dimensional computed tomography scans indicated abnormal sacral vertebrae with the sacral canal partially enlarged and opened. Pelvic magnetic resonance imaging showed a 55 mm × 40 mm × 35 mm unilocular cystic mass in the perirectal space and a solitary sinus in the left ischiorectal fossa. The cyst was completely resected posteriorly using the sacrococcygeal approach. The pathology was verified to be an epidermoid cyst. The patient remained recurrence-free after 6 mo of follow-up.

CONCLUSION

Successful treatment of perirectal epidermoid cysts depends on comprehensive evaluation. This is significant for the surgical approach and prognosis.

Laparoscopic management of epidermoid cyst in an unusual location

The pararectal space or presacral space is a potential site for various cysts and tumours because it consists of many types of embryonic tissues. Although epidermoid cyst is a well-known entity, encountering a pararectal epidermoid cyst is relatively rare. The incidence of cystic tumours in the pararectal space has been reported to be 1 in 40 000 to 63 000 patients. Most of the tumours are asymptomatic and are incidentally discovered during routine imaging studies. Herein, we report a case of pararectal epidermoid cyst in a 51-year-old woman which was managed laparoscopically in a gastroenterology institute in South India.