A CASE OF PRESACRAL EPIDERMOID CYST

Abstract

A 43-year-old woman visited the department of obsterics and gynecology in our hospital because of dysfunctional uterine bleeding. CT visualized an internally homogeneous cystic tumor with the diameter of 6cm in the presecral region, and a projection continued to the tumor as a high-density area. Transrectal ultrasonography revealed a tumor covered with a thin capsule with homogeneous internal punctate echo. It was diagnosed as developmental cyst of the presacral region, and the operation was caried out. Upon laparotomy the tumor was placed in the left broad ligament of the uterus and extended to the coccyx. The tumor contained muddy substance brown to white in color. Histpathologically, the cyst wall was consisted of stratified squamous epitherium and the diagnosis of epidermoid cyst was made. A variety of congenital tumors can occur in the presacral region because the region is a border where the endoblast, mesoblast, and ectoblast are adjoining. Care must be taken to differentiate the developmental cyst from teratoma which should be treated by each different appropriate operative procedure.