Surgical Treatment of Benign Retrorectal Masses in Adults: A Retrospective Study

Background: Tumors that occur in the retrorectal space are called retrorectal tumors. These tumors arise from various tissues. Late symptoms may therefore outweigh diagnosis and treatment. Therefore, the surgery becomes difficult. Aims and Objectives: Our study aims to reveal the difficulties in the diagnosis of retrorectal tumors, radiological diagnostic methods, and safe surgical excision surgical techniques. Materials and Methods: Twelve patients operated for retrorectal tömür between 2014 and 2020 were included in the retrospective study. Demographic features, clinical findings, diagnostic methods, surgical treatment procedures, evaluations of preoperative/postoperative complications, pathological classifications, length of hospital stay, and duration of surgery were studied. Results: Twelve patients [9 females, 3 males; the mean age was 39.3 ± 11.8 (22-56)] due to retrorectal tumors. All lesions were evaluated preoperatively using magnetic resonance imaging (MRI). According to the preoperative examination and radiological findings; Surgical resection was performed with an anterior approach to 3 patients, a posterior approach to 4 patients, and a combined approach to 5 patients. The mean tumor size was 8 ± 2.24 cm. Immature teratoma and epidermoid cyst (n = 6) were the most common tumors. We did not have any patients with features of malignancy on final histopathology. Conclusion: Although retrorectal tumors are difficult to diagnose, it is important to suspect clinically. A good evaluation of the patients with radiological imaging facilitates the resection of the tumor surgically. Surgery of the patient in centers specialized in these tumors increases surgical success.

A rare presentation of abdominal pain as cloacal cyst: A case report

Retrorectal hamartoma or tailgut cyst is an uncommon congenital disease of presacral and retrorectal space and is embryologically part of some forms of enteric cysts. The rarity of this disease leads to difficulty in diagnosis and surgical management. Complete surgical excision is the treatment of choice for tailgut cysts. We present a case of a 40-year-old man, who presented to us with abdominal pain for four months, which had become more prominent while defecation and after eating. Abdominal computed tomography demonstrated a cyst in the lower interperitoneal cavity. Surgical complete excision of the mass was done with midline laparotomy. Histopathology confirmed cloacal cyst.

Tailgut cyst: from differential diagnosis to surgical resection—case report and literature review

Tailgut cyst is a rare tumor originating from the embryonic remnant located in the retrorectal space. The diagnosis is usually incidental duse to the absence of symptoms. When present, they are nonspecific, such as abdominal pain, dysuria and tenesmus. Imaging tests are a great help in the diagnosis and surgical planning. The standard treatment is resection, which the surgeon must perform to avoid future complications, such as malignancy. We present a case of tailgut cyst in a young patient with prior pilonidal cyst excision, subsequently submitted to surgical resection, to share our experience with a rare case, with few reports in the literature.

Retrorectal cyst: proteus in the backyard—case series and literature review

Retrorectal cysts are cystic lesions located in the retrorectal space and are a distinct subset of retrorectal tumours, which are often misdiagnosed due to their rarity and mimicry of symptoms caused by common diseases. We have described the presentation and management of four patients who were diagnosed with retrorectal cysts from a 10-year retrospective chart review at our institute, a tertiary care centre. In middle-aged women, the following should raise suspicion of retrorectal cyst: gastrointestinal or urinary obstructive features, mass or fullness palpable on the posterior wall on digital rectal examination, presacral dimple, perianal fistula and/or recurrent disease. Such features should prompt an MRI evaluation of the pelvis for definitive diagnosis.

Laparoscopic Resection of a Huge Retrorectal Tumor

Retrorectal space tumors are rare, and so are frequently unrecognized, misdiagnosed, and mistreated. A 57-year-old man visited the outpatient clinic with the chief complaints of thin stool and lower pelvic heaviness. A smooth, round huge palpable mass on the right posterolateral rectal wall was detected and pelvic computed tomography showed a 7.8-cm cystic lesion in the right retrorectal space. Laparoscopic procedures were initiated with perirectal dissection for rectal mobilization. After fixation of the peritoneum and tying the rectum for intracorporeal traction, the rectum was mobilized to identify the cyst. The cyst was removed using an endo-bag, with completion of cyst dissection. The final pathologic diagnosis was a tailgut cyst, or retrorectal cystic hamartoma without evidence of malignancy. The patient was discharged without any complications. The patient had no dyschezia or problems with bowel function. Laparoscopic resection is a safe and feasible method for surgical treatment, even for bulky retrorectal tumors, with an early recovery period.

CHRONIC CONSTIPATION IN INFANTS: THINK ABOUT RECTAL DUPLICATION

Rectum is the least common site of gastrointestinal duplication. Up to now fewer than 100 cases have been reported in the literature. We present two infants with cystic rectal duplications manifested with chronic constipation as a main clinical symptom. The first patient was a 4-year-old boy who was admitted to emergency department because of chronic constipation unresponsive to fiber supplements and laxatives. Digital rectal exam revealed mass adjacent to posterior rectal wall. Abdominal ultrasound and magnetic resonance imaging confirmed oval, homogenous and hypoechogenic cystic mass (87x65x60 mm in size) behind the rectum. The size and location of the cystic mass was confirmed by magnetic resonance imaging. The second patient was an 11-month-old boy who was hospitalized due to rectal bleeding. He was suffering from chronic constipation over the last five months. Digital rectal exam revealed a mass behind the rectum. Abdominal ultrasound and computed tomography showed unilocular cyst (33X33 mm in size) in front of the urinary bladder, partly extending into retrorectal space. Both patients were operated on. Postoperative periods were uneventful in both of them. Cystic rectal duplication must be ruled out in all infants with chronic constipation unresponsive to conservative treatment. Different imaging techniques are currently used to determine the precise size and location of duplication. Surgery is the only possible therapy option.

Pediatric congenital buttock sinus tract: 10-year experience in a single institution

Purpose: To review our experience with pediatric congenital buttock sinus tract, and to conclude the clinical characteristics and management of the disease. Methods: Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Continuous variables were presented by median and range. Categorical variables were presented as frequencies and percentages. Results: Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). The median first onset age was 42 months, and the range was 5 months to 12 years old. Admission age was 69.5 months, with a range from 14 months to 12 years old. Overall prior treatment time was 11 months, ranging from 3 months to 11 years. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.5 months (range, 2 months to 8 years), 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions: Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst. Keywords: Pediatric, Buttock sinus tract, Retrorectal cyst, Treatment, Prognosis

Pediatric congenital buttock sinus tract: 10-year experience in a single institution

Purpose: To review our experience with pediatric congenital buttock sinus tract, and to conclude the clinical characteristics and management of the disease. Methods: Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Continuous variables were presented by median and range. Categorical variables were presented as frequencies and percentages. Results: Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). The median first onset age was 42 months, and the range was 5 months to 12 years old. Admission age was 69.5 months, with a range from 14 months to 12 years old. Overall prior treatment time was 11 months, ranging from 3 months to 11 years. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.5 months (range, 2 months to 8 years), 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions: Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst. Keywords: Pediatric, Buttock sinus tract, Retrorectal cyst, Treatment, Prognosis

Pediatric congenital buttock sinus tract:10-year experience in a single institution

Purpose To review our experience with pediatric congenital buttock sinus tract, and to conclude the clinical characteristics and management of the disease. Methods Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Continuous variables were presented by median and range. Categorical variables were presented as frequencies and percentages. Results Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). The median first onset age was 42 months, and the range was 5 months to 12 years old. Admission age was 69.5 months, with a range from 14 months to 12 years old. Overall prior treatment time was 11 months, ranging from 3 months to 11 years. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.5 months (range, 2 months to 8 years), 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst.