Giant pelvic dermoid cyst in a 17-year-old girl
- Authors: Zhurilo I.P.1, Medvedev A.I.1, Chernogorov O.L.2
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Affiliations:
- Orel State University
- Scientific and Clinical Multidisciplinary Center named after Z.I. Kruglaya
- Issue: Vol 28, No 5 (2024)
- Pages: 512-517
- Section: CASE REPORTS
- Submitted: 03.02.2024
- Accepted: 23.09.2024
- Published: 11.11.2024
- URL: https://jps-nmp.ru/jour/article/view/788
- DOI: https://doi.org/10.17816/ps788
- ID: 788
Cite item
Abstract
BACKGROUND: Dermoid cysts in the presacral and retrorectal space in children are relatively rare. However, even more rarely, they have clinical manifestations at patient’s early age and so, can be silent for a long time.
CLINICAL CASE DESCRIPTION: The article describes a rare clinical observation — a giant dermoid cyst in the retrorectal space in a 17-year-old girl. The child had a tendency to constipation from her early childhood. Menses started at age 13, painful. During the last year, disorders in her menstrual cycle were noticed. The girl was examined by a gynecologist. Ultrasound examination revealed a cystic formation in the pelvic cavity up to 9 cm in diameter. Non-malignant nature of the process was confirmed by: normal level of cancer markers (α-fetoprotein, β-human chorionic gonadotropin), single node, clearly defined formation capsule, homogeneous nature of its contents, no invasive growth and lesions in the regional lymph nodes. Magnetic resonance imaging with intravenous contrasting defined a true relationship of the cystic formation with other organs and structures of the pelvic cavity. The cystic formation caused deformation of the cervix, vagina, and rectum. The obtained findings allowed to plan surgical intervention correctly. Surgical access-transverse in the coccyx projection up to 10 cm long. The cystic formation was a thin-walled connective tissue capsule with a yellowish content. Due to very large cyst dimensions, first it was opened in a limited area and emptied. Then the capsule was isolated and completely removed. The cyst intimately adhere to rectum, vagina, and cervix walls. Histological conclusion: "Capsule of a dermoid cyst with hemorrhages". The postoperative period was smooth. The patient recovered, all disease manifestations disappeared. She was discharged home in a satisfactory state. Follow-up visits were in 6 and 12 months after surgery. No evidence of possible relapse.
CONCLUSION: There are only few descriptions of such cases in the available literature. Ultrasound and MRI examinations allowed to have a full picture of dermoid cyst position and its connection with other pelvic organs due to which surgeons could develop a correct plan for surgical intervention.
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About the authors
Ivan P. Zhurilo
Orel State University
Author for correspondence.
Email: zhipsurg@mail.ru
ORCID iD: 0000-0003-1836-979X
SPIN-code: 9056-7448
MD, Dr. Sci. (Medicine), Professor
Россия, OrelAlexey I. Medvedev
Orel State University
Email: maiorel@yandex.ru
ORCID iD: 0000-0003-1966-3771
SPIN-code: 6153-8947
MD, Cand. Sci. (Medicine)
Россия, OrelOleg L. Chernogorov
Scientific and Clinical Multidisciplinary Center named after Z.I. Kruglaya
Email: olch912@mail.ru
ORCID iD: 0000-0001-7162-7263
SPIN-code: 3246-9114
Россия, Orel
References
- Nikitina ON. Presacral cyst. Pediatric surgery: National guidelines. Razumovsky AYu, editor. 2nd edition. Moscow: GEOTAR-Media; 2021. Р. 416–417. (In Russ.) doi: 10.33029/9704-5785-6-PSNR-2021-2-1-1280
- Karaseva OV, Golikov DE, Gorelik AL, et al. A rare clinical observation of a dermoid cyst and isolated doubling of the small intestine in the retroperitoneal space in a 15-year-old girl. Detskaya khirurgiya (Russian Journal Pediatric Surgery). 2019;23(6):339–343. EDN: VCKMUP doi: 10.18821/1560-9510-2019-23-6-339-343
- Nechushkina IV, Kapkova OA, Kazantsev AP, et al. Germ cell tumors. Pediatric surgery: National guidelines. Razumovsky AYu, editor. 2nd edition. Moscow: GEOTAR-Media; 2021. Р. 1202–1215. (In Russ.) doi: 10.33029/9704-5785-6-PSNR-2021-2-1-1280
- Poudel D, Shrestha BM, Kandel BP, et al. Presacral dermoid cyst in a young female patient: A case report. Clinical Case Rep. 2021;9(11):e05062. doi: 10.1002/ccr3.5062
- Messick CA, Hull T, Rosselli G, Kiran RP. Lesions originating within the retrorectal space: A diverse group requiring individualized evaluation and surgery. J Gastrointest Surg. 2013;17(12):2143–2152. EDN: YJLBEY doi: 10.1007/s11605-013-2350-y
- Li Z, Lu M. Presacral tumor: Insights from a decade’s experience of this rare and diverse disease. Front Oncol. 2021;16(11):639028. doi: 10.3389/fonc.2021.639028
- Ma X, Xiao J, Wang W. Retroperitoneal dermoid cyst mimicking a liposarcoma based on imaging assessment: Case report and literature review. Gland Surg. 2021;10(6):2062–2068. doi: 10.21037/gs-21-65
- Glasgow SC, Birnbaum EH, Lowney JK, et al. Retrorectal tumors: A diagnostic and therapeutic challenge. Dis Colon Rectum. 2005;48(8):1581–1587. doi: 10.1007/s10350-005-0048-2
- Mullaney TG, Lightner AL, Johnston M, et al. A systematic review of minimally invasive surgery for retrorectal tumors. Tech Coloproctol. 2018;22(4):255–263. EDN: QAROPP doi: 10.1007/s10151-018-1781-6
- Zhao X, Zhou S, Liu N, Chen L. Is There another posterior approach for presacral tumors besides the kraske procedure? A study on the feasibility and safety of surgical resection of primary presacral tumors via transsacro-coccygeal transverse incision. Front Oncol. 2022;26(12):892027. EDN: VSPVZK doi: 10.3389/fonc.2022.892027