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Case Reports
. 2020 Nov 2;12(11):e11300.
doi: 10.7759/cureus.11300.

Retrorectal Epidermal Inclusion Cyst: An Incidental Finding During Cesarean Section

Sundus Nasim  1 , Sohail Kumar  1 , Dua Azim  1 , Lajpat Rai  2 , Summaya Saeed  2
Affiliations
Case Reports

Retrorectal Epidermal Inclusion Cyst: An Incidental Finding During Cesarean Section

Sundus Nasim et al. Cureus. .

Abstract

An epidermal inclusion cyst is a benign lesion, frequently observed throughout the body. However, its presence in the retrorectal region is a rare occurrence. With a higher incidence in women and non-specific symptoms, these cysts are mostly an incidental finding. Here, we report a case of a 33-year-old female presenting with complaints of abdominal pain and sensation of incomplete and painful defecation. The patient's history revealed that a large pelvic cyst was found incidentally during her first cesarean section (CS) owing to an arrest in labor. A presumptive diagnosis of rectal duplication cyst was made based on digital rectal exam (DRE), computed tomography (CT), and magnetic resonance imaging (MRI) findings. For cyst removal, the patient underwent a midline laparotomy. A postoperative biopsy led to the confirmed diagnosis of the retrorectal epidermal inclusion cyst. On follow-up, our patient showed a smooth recovery without any complications. We conclude that when dealing with a pregnant woman with a pelvic mass, developmental cysts should always be kept in mind. Timely diagnosis and management of a retrorectal mass is essential for effective treatment and to prevent subsequent complications.

Keywords: cyst; epidermoid; inclusion cyst; presacral; retrorectal.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT scan showing a well-defined cystic area anterior to the sacrum, displacing the rectum towards the left
CT, computed tomography
Figure 2
Figure 2. T1W-MRI showing a large, hypointense lesion in the presacral space
T1W, T1-weighted; MRI, magnetic resonance imaging
Figure 3
Figure 3. T2W-MRI showing a large, slightly hyperintense lesion in the presacral space
T2W, T2-weighted; MRI, magnetic resonance imaging
Figure 4
Figure 4. Intraoperative image showing a large retrorectal cyst in the presacral space
Figure 5
Figure 5. Large amounts of cheesy material released due to rupture of the cyst during excision
See this image and copyright information in PMC

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