A Case of Epidermal Cyst Extending into the Pelvic Cavity Treated with Laparoscopic Transabdominal and Transsacral Surgery

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  • Imanishi Suzuka
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Takahashi Yusuke
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Kato Takeshi
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Mori Kiyoshi
    Department of Pathology, National Hospital Organization Osaka National Hospital
  • Tokuyama Shinji
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Kawai Kenji
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Toshiyama Reishi
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Sakai Kenji
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Takeno Atsushi
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Gotoh Kunihito
    Department of Surgery, National Hospital Organization Osaka National Hospital
  • Miyazaki Michihiko
    Department of Anal Surgery, National Hospital Organization Osaka National Hospital
  • Hirao Motohiro
    Department of Surgery, National Hospital Organization Osaka National Hospital

Bibliographic Information

Other Title
  • 骨盤内に進展した臀部表皮囊腫に対して腹腔鏡アプローチを併用し経仙骨的に切除した1例

Abstract

<p>A 34-year-old woman presented with a complaint of swelling of the buttock. A physical examination indicated a subcutaneous soft elastic tumor. CT and MRI showed a 6-cm subcutaneous dumbbell-shaped cystic tumor in the buttock, extending into the pelvic cavity. Laparoscopic resection with a transsacral approach was performed without an accurate preoperative diagnosis. Laparoscopically we found a subcutaneous tumor in the buttock penetrating into the pelvic cavity on the dorsal side of the mesorectum, through the gap of the levator ani muscle around the coccygeal bone. The cystic tumor and coccygeal bone were totally resected. Pathological findings of the specimen revealed a cyst wall composed of squamous epithelium that contained atheromatous contents. The lesion was diagnosed as an epidermal cyst. The patient was discharged from hospital on the eighth postoperative day without any complications. There has been no recurrence of symptoms after surgery. An epidermal cyst is a benign tumor that is commonly experienced in daily medical practice. Malignant transformation of epidermal cysts are reported on rare occasions, and total resection of the tumor is recommended. This case shows that transsacral resection with laparoscopic surgery for cystic tumors extending from the buttocks into the pelvic cavity is a safe and appropriate surgical approach.</p>

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