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Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults

대한대장항문학회지 2011년 27권 6호 p.303 ~ 314
 ( Baek Sung-Wook ) - Seoul Song Do Colorectal Hospital Department of Surgery

 ( Kang Haeng-Ji ) - Seoul Song Do Colorectal Hospital Department of Pathology
 ( Yoon Ji-Yong ) - Seoul Song Do Colorectal Hospital Department of Radiology
 ( Whang Do-Youn ) - Seoul Song Do Colorectal Hospital Department of Surgery
 ( Park Duk-Hoon ) - Seoul Song Do Colorectal Hospital Department of Surgery
 ( Yoon Seo-Gue ) - Seoul Song Do Colorectal Hospital Department of Surgery
 ( Kim Hyun-Sik ) - Seoul Song Do Colorectal Hospital Department of Surgery
 ( Lee Jong-Kyun ) - Seoul Song Do Colorectal Hospital Department of Surgery
 ( Lee Jung-Dal ) - Seoul Song Do Colorectal Hospital Department of Pathology
 ( Kim Kwang-Yun ) - Seoul Song Do Colorectal Hospital Department of Surgery

Abstract


Purpose: A retrorectal developmental cyst (tailgut cyst, epidermoid cyst, dermoid cyst, teratoma, and duplication) is very rare disease, and the symptoms are not characteristic so that sometimes this disease is still misdiagnosed as a supralevator abscess or a complex anal fistula. We would like to present a clinical approach to this disease.

Methods: We retrospectively examined the charts of 15 patients who were treated for retrorectal cysts from January 2001 to November 2009.

Results: All 15 patients were female. The average age was 41 years (range, 21 to 60 years). Fourteen patients (93.3%) were symptomatic, and the most common symptom was anal pain or discomfort. Nine patients (60%) had more than one previous operation (range, 1 to 9 times) for a supralevator abscess, an anal fistula, etc. In 12 patients (80%), the diagnosis could be made by using the medical history and physical examination. Thirteen cysts (80%) were excised completely through the posterior approach. The average diameter of the cysts was 4.8 cm (range, 2 to 10 cm). Pathologic diagnoses were 8 tailgut cysts (53.3%), 5 epidermoid cysts (33.3%) and 2 dermoid cysts (13.3%). The average follow-up period was 18.3 months (range, 1 to 64 months).

Conclusion: In our experience, high suspicion and physical examination are the most important diagnostic methods. If a female patient has a history of multiple perianal operations, a retrorectal bulging soft mass, a posterior anal dimple, and no conventional creamy foul odorous pus in drainage, the possibility of a retrorectal developmental cyst must be considered.

키워드

Retrorectal tumor; Tailgut cyst; Epidermoid cyst; Dermoid cyst
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