A Case of Epidermal Cyst in the Retrorectum Safely Resected by a Combined Laparoscopic Approach

TL;DR

A rare retrorectal epidermal cyst was successfully removed using a combined laparoscopic approach, avoiding complications and showing no recurrence after one year.

Contribution

Demonstrates the effectiveness of a combined laparoscopic transabdominal and trans-sacral approach for safely resecting retrorectal tumors.

Findings

A 48-year-old patient had a retrorectal epidermal cyst safely removed using laparoscopic techniques.

The combined surgical approach allowed complete tumor excision without complications or recurrence after one year.

Laparoscopy provided enhanced visualization and precision in dissecting the anatomically complex presacral space.

Abstract

The surgical indications and optimal approach for retrorectal tumors remain unclear due to their rarity and the anatomical complexity of the presacral space. We report the case of a 48‐year‐old man in whom a retrorectal mass was incidentally detected on abdominal and pelvic computed tomography. Magnetic resonance imaging demonstrated a cystic lesion measuring 32 × 12 × 20 mm, with low signal intensity on T1‐weighted and high signal intensity on T2‐weighted images. Given the difficulty of establishing a definitive diagnosis and the potential risk of infection or tumor seeding with biopsy, primary surgical resection was selected. A combined laparoscopic transabdominal and trans‐sacral approach enabled precise dissection under enhanced visualization of the pelvic anatomy, ensuring safe and complete tumor excision. The patient's postoperative course was uneventful, and he remained recurrence‐free at the 1‐year follow‐up. This case highlights the pivotal role of laparoscopy in facilitating the safe resection of retrorectal tumors.

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