J Korean Assoc Pediatr Surg.  2015 Dec;21(2):35-37. 10.13029/jkaps.2015.21.2.35.

Median Raphe Cyst in a 2-Year-Old Boy

Affiliations
  • 1Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea. kpnugs@knu.ac.kr

Abstract

Median raphe cyst (MRC) of the perineum is rare congenital midline cyst of the male genitalia. MRC is thought to be caused by congenital alterations in the embryologic development of the male genitalia during fetal life. MRC can be found on the midline position between the urethral meatus and the anus. The lesion can be cystic, but sometimes it looks like an elongated configuration called a raphe canal. Diagnosis in childhood is particularly rare because they are usually asymptomatic, but some cases have reportedly been identified after infection. Although conservative treatment can be possible in small asymptomatic lesions, the treatment of choice is simple excision followed by primary closure in symptomatic cases. We describe here the case of 2-year-old boy presented at our institution with a 10-month history of anomaly of the perineal median raphe, which was treated by surgical excision.

Keyword

Median raphe cyst; Male genitalia; Perineum

MeSH Terms

Anal Canal
Child, Preschool*
Diagnosis
Genitalia, Male
Humans
Male*
Perineum

Figure

  • Fig. 1 A 2-year-old boy presents with median raphe cyst of the perineum.

  • Fig. 2 Perineal ultrasonography reveals hypoechoic tubular mass without any communication between the mass and other organ.

  • Fig. 3 Probing with lacrimal gland probe demonstrates a unilocular tubular lesion.

  • Fig. 4 Histopathologic finding reveals that the unilocular cystic cavity is lined by a stratified squamous epithelium (H&E, ×40).

  • Fig. 5 Some part shows the granulomatous foreign body reaction (H&E, ×100).


Reference

1. Soyer T, Karabulut AA, Boybeyi Ö, Günal YD. Scrotal pearl is not always a sign of anorectal malformation: median raphe cyst. Turk J Pediatr. 2013; 55:665–666.
2. Krauel L, Tarrado X, Garcia-Aparicio L, Lerena J, Suñol M, Rodó J, et al. Median raphe cysts of the perineum in children. Urology. 2008; 71:830–831.
3. Ravasse P, Petit T, Pasquier CJ. Perineal median raphe canal: a typical image. Urology. 2002; 59:136.
4. Park CO, Chun EY, Lee JH. Median raphe cyst on the scrotum and perineum. J Am Acad Dermatol. 2006; 55:5 Suppl. S114–S115.
5. Navarro HP, Lopez PC, Ruiz JM, Martinez Sanchiz C, Cha SH, Sanchez AS, et al. Median raphe cyst. Report of two cases and literature review. Arch Esp Urol. 2009; 62:585–589.
6. Sagar J, Sagar B, Patel AF, Shak DK. Ciliated median raphe cyst of perineum presenting as perianal polyp: a case report with immunohistochemical study, review of literature, and pathogenesis. ScientificWorldJournal. 2006; 6:2339–2344.
7. Lee JN, Kim HT, Chung SK. Median raphe cysts of the scrotum and perineum presenting with recurrent infection. Korean J Urogenit Tract Infect Inflamm. 2014; 9:119–121.
8. Jung JY, Kim DY, Park CO, Chung HJ, Lee MG. A case of median raphe cyst on the scrotum with atypical histologic features. Korean J Dermatol. 2006; 44:1109–1113.
9. Chung SJ, Shin JH, Kim KH, Kim KJ. A case of median raphe cyst. Korean J Dermatol. 2000; 38:1260–1261.
10. Heo YS, Kwon JI, Park RW, Kim YS. Two cases of median raphe cyst of male external genitalia. Korean J Urol. 2000; 41:349–351.
11. Shibagaki N, Ohtake N, Furue M. Spontaneous regression of congenital multiple median raphe cysts of the raphe scroti. Br J Dermatol. 1996; 134:376–378.
Full Text Links
  • JKAPS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr