Abstract
Background: A 51-year-old previously healthy woman presented with a perianal mass. The mass has been there for some years and has gradually increased in size ever since with progressive pain when she sits. There was no history of trauma nor injections in this region. Clinically, the mass was not tender and rather soft, with superficially some focal harder spots. A large lipoma was suspected on clinical basis. An ultrasonography and subsequent MRI scan, including sequences following administration of gadolinium contrast medium were performed.
Highlights
A 51-year-old previously healthy woman presented with a perianal mass
EPIDERMAL INCLUSION CYST — NICOLAY et al Ultrasonography of the perianal region (Fig. 1) shows an iso- to hyperreflective, well-circumscribed subcutaneous mass extending to the deeper perianal tissues
MRI of the pelvis (Fig. 2) shows on A a well-circumscribed homogeneous structure located in the left perianal region
Summary
A 51-year-old previously healthy woman presented with a perianal mass. The mass has been there for some years and has gradually increased in size ever since with progressive pain when she sits. Ultrasonography of the perianal region (Fig. 1) shows an iso- to hyperreflective, well-circumscribed subcutaneous mass extending to the deeper perianal tissues. MRI of the pelvis (Fig. 2) shows on A (axial T1weighted image) a well-circumscribed homogeneous structure located in the left perianal region. On B (axial T2-weighted image), the lesion has a predominantly high signal intensity, suggesting a fluid containing, cystic lesion. On coronal T2-weighted image with fat saturation (D), the lesion shows a homogeneous very high signal intensity. Sagittal T1weighted image with fat saturation (E) demonstrates high signal intensity, confirming the absence of fat in the lesion. This sagittal image shows well the extent of the lesion from the left perianal region through the ischiorectal fossa into the pelvis.
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