Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2022; 10(30): 11139-11145
Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11139
Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report
Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang
Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang, Department of Anorectal Surgery, Shenzhen People's Hospital, Shenzhen 518000, Guangdong Province, China
Author contributions: Yao Q was the first to treat patients in the clinic, Yan S and Ji ZX were involved in managing the patients and assisting in the operation; Wang D was the main surgeon; Ji ZX prepared the manuscript and drafted it; Lin LF and Li Q prepared the images; Wang D revised the manuscript and is the corresponding author; All authors contributed to the article and approved the submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest, financial or otherwise.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhou-Xin Ji, MD, Researcher, Department of Anorectal Surgery, Shenzhen People's Hospital, No. 1017 Dongmen North Road, Luohu District, Shenzhen 518000, Guangdong Province, China. 675893363@qq.com
Received: June 25, 2022
Peer-review started: June 25, 2022
First decision: August 1, 2022
Revised: August 9, 2022
Accepted: September 20, 2022
Article in press: September 20, 2022
Published online: October 26, 2022
Processing time: 117 Days and 17.4 Hours
Abstract
BACKGROUND

Perirectal epidermoid cysts are rare masses arising from the ectodermal germ cell layer of the hindgut and are predominantly found in middle-aged women. It is often difficult to make an accurate diagnosis of these cysts and it is equally challenging to distinguish it from other developmental cysts.

CASE SUMMARY

We report the case of an 18-year-old female patient with a perirectal mass who presented to the hospital with constipation. The patient experienced sacrococcygeal falls and burns on the left buttocks during growth. Three-dimensional computed tomography scans indicated abnormal sacral vertebrae with the sacral canal partially enlarged and opened. Pelvic magnetic resonance imaging showed a 55 mm × 40 mm × 35 mm unilocular cystic mass in the perirectal space and a solitary sinus in the left ischiorectal fossa. The cyst was completely resected posteriorly using the sacrococcygeal approach. The pathology was verified to be an epidermoid cyst. The patient remained recurrence-free after 6 mo of follow-up.

CONCLUSION

Successful treatment of perirectal epidermoid cysts depends on comprehensive evaluation. This is significant for the surgical approach and prognosis.

Keywords: Perirectal mass; Epidermoid cyst; Surgery; Anal sinus; Case report

Core Tip: Perirectal cystic mass is a rare congenital developmental abnormality. An 18-year-old female was found with a perirectal mass due to defecation difficulties. She had suffered from sacrococcygeal falls and burns on the left buttocks during the growth experience. We performed a complete preoperative evaluation of this patient. Three-dimensional computed tomography scans showed that there was no damage to the sacral surface bone. Pelvic magnetic resonance imaging showed that the perirectal mass had a complete membrane without enhancement signs and no potential connection with the perianal sinus and sacral canal. Finally, the mass was completely removed through the sacrococcygeal approach and verified as an epidermoid cyst in histology. This case highlights the need to improve evaluation in the differential diagnosis of perirectal mass.