ABSTRACT

Introduction:

Retrorectal tumors are rare and often present with nonspecific symptoms, leading to delayed diagnosis. Epidermoid cysts constitute an uncommon subgroup of retrorectal lesions and are typically benign; however, they may rarely undergo malignant transformation or develop secondary to trauma or surgery.

Case Presentation:

We report a very rare case of a retrorectal epidermoid cyst in a 66-year-old man that developed following a fistulectomy. The patient presented with an erythematous bulge in the sacrococcygeal region associated with mild tenderness and a palpable mass on the right side of the rectum. Imaging studies revealed a retrorectal cystic lesion. Surgical excision was performed, and the specimen was submitted for histopathological examination, which confirmed the diagnosis of an epidermoid cyst.

Discussion:

Retrorectal epidermoid cysts are rare and may be either congenital or acquired. Surgical implantation of epithelial elements following procedures such as fistulectomy may contribute to their development. Despite their benign nature, these cysts carry a risk of recurrence and, rarely, malignant transformation, necessitating complete surgical excision.

Conclusions:

Retrorectal epidermoid cysts should be considered in patients presenting with presacral masses, particularly those with a history of prior anorectal surgery. Early diagnosis and complete surgical excision are essential to achieve optimal outcomes and prevent recurrence.

Keywords: Retrorectal tumor; Epidermoid cyst; Epidermal inclusion cyst; Fistulectomy; Presacral mass; Case report