A Case of Presacral Cyst Histologically Suspected to be a Pseudocyst

Chihiro Ono¹⁾²⁾, Kanji Yaegashi¹⁾, Haruhiko Aoyagi¹⁾, Yoshinobu Nishioka¹⁾, Hisatsugu Nishimura¹⁾ and Kenichi Sugihara³⁾

Department of Surgery, Soka Municipal Hospital¹⁾
Department of Surgery, National Printing Bureau Tokyo Hospital²⁾
Department of Surgical Oncology, Tokyo Medical and Dental University Graduate School of Medicine³⁾

A 28-year-old man referred for examination of a pelvic mass found in an assessment of constipation and dysuria was found in pelvic CT and MRI to have a 14×9×10 cm presacral calcified cystic mass. Barium enema and colonoscopic examination showed that the posterior wall of the rectum was notably displaced anteriorly. Biopsy during colonoscopy showed no atypical cells. The mass, excised transabdominally, was posterior to the rectum, anterior to the sacrum, and partially attached to the sacrum and firmly to the coccyx. Macroscopically, it had a thick wall containing hemorrhagic fluid and necrotic materials. Histological examination showed a thick fibrous wall free of epithelial cell lining and containing granulation tissue with cholesterin crystals. Therefore the mass was suspected to be a pseudocyst. His complaints were ameliorated clinically and he was discharged on post-operative day 26. Presacral pseudocysts are extremely rare and have not, to our knowledge, been reported previously in Japan.

Key words
pseudocyst, presacral cyst, retrorectal mesenteric cyst

Reprint requests
Chihiro Ono Department of Surgery, Soka Municipal Hospital
2-21-1 Soka, Soka, 340-8560 JAPAN

Accepted
February 23, 2005

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