A Case of Adult Presacral Epedermoid Cyst

Yoshihiko Tsukamoto, Masahiro Samizo, Tetsuya Takahashi, Takayo Maekawa and Masaru Miyashita

Department of Surgery, Konan Hospital

A 31-year-old woman seen for a genital bleeding was found in palpation and digital examination to have an elastic soft, smooth unmovable tumor on the right behind the lower rectum. Barium enema and colonoscopy showed extrarectal compression of the right posterior lower rectum. CT and MRI showed a presacral cystic tumor, 63×47×80 mm, which we resected in using a sacral approach in the jack knife position. Macroscopically, the smooth surfaced cyst cotained white mucous material, with no tumorous lesion seen in the wall. Microscopically, the inner cyst wall consisted of keratinized squamous epithelium. No sebaceous glands or hair was found. The cyst was diagnosed as epidermoid. We review 57 cases of presacral epidermoid cyst including our case, reported in Japan. We believe presacral cysts must be completely excised because of possible complications including squamous cell carcinoma and infection. Presacral epidemoid cyst should be treated by appropriate operative procedures, based on, the tumor location, direction of the growth and tumor size.

Key words
epidermoid cyst, presacral tumor, adult

Reprint requests
Yoshihiko Tsukamoto Department of Surgery, Konan Hospital
1-5-16 Kamokogahara, Higashinada-Ku, Kobe, 658-0064 JAPAN

Accepted
November 28, 2007

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