J Korean Soc Coloproctol.  2011 Dec;27(6):303-314. 10.3393/jksc.2011.27.6.303.

Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults

• Baek SW
• Kang HJ
• Yoon JY
• Whang DY
• Park DH
• Yoon SG
• Kim HS
• Lee JK
• Lee JD
• Kim KY

• KMID: 2101579
• DOI: http://doi.org/10.3393/jksc.2011.27.6.303

Abstract

PURPOSE
A retrorectal developmental cyst (tailgut cyst, epidermoid cyst, dermoid cyst, teratoma, and duplication) is very rare disease, and the symptoms are not characteristic so that sometimes this disease is still misdiagnosed as a supralevator abscess or a complex anal fistula. We would like to present a clinical approach to this disease.
METHODS
We retrospectively examined the charts of 15 patients who were treated for retrorectal cysts from January 2001 to November 2009.
RESULTS
All 15 patients were female. The average age was 41 years (range, 21 to 60 years). Fourteen patients (93.3%) were symptomatic, and the most common symptom was anal pain or discomfort. Nine patients (60%) had more than one previous operation (range, 1 to 9 times) for a supralevator abscess, an anal fistula, etc. In 12 patients (80%), the diagnosis could be made by using the medical history and physical examination. Thirteen cysts (80%) were excised completely through the posterior approach. The average diameter of the cysts was 4.8 cm (range, 2 to 10 cm). Pathologic diagnoses were 8 tailgut cysts (53.3%), 5 epidermoid cysts (33.3%) and 2 dermoid cysts (13.3%). The average follow-up period was 18.3 months (range, 1 to 64 months).
CONCLUSION
In our experience, high suspicion and physical examination are the most important diagnostic methods. If a female patient has a history of multiple perianal operations, a retrorectal bulging soft mass, a posterior anal dimple, and no conventional creamy foul odorous pus in drainage, the possibility of a retrorectal developmental cyst must be considered.

Keyword

Retrorectal tumor; Tailgut cyst; Epidermoid cyst; Dermoid cyst

MeSH Terms

Abscess
Adult
Dermoid Cyst
Drainage
Epidermal Cyst
Female
Follow-Up Studies
Humans
Odors
Physical Examination
Rare Diseases
Rectal Fistula
Retrospective Studies
Suppuration
Teratoma