A Case of Infected Presacral Epidermoid Cyst with Perianal Abscess

Abstract

A 70-year-old man was admitted to our hospital with coccygeal pain and anal discomfort. A painful mass was palpated on the right hip, and a computed tomography scan revealed a 90×75-mm multilocular cyst in the presacral space and a right hip abscess. We diagnosed an infected presacral cystic tumor with perianal abscess and performed incisional drainage of the abscess. However, due to recurrence of fever and pain, we performed the tumor resection using the transsacral approach with removal of the coccygeal bone at postoperative day-15. Histopathologically, the patient was diagnosed with an epidermoid cyst without malignancy.

The presacral space is known to be the origin of various tumors that develop from embryonic structures. These tumors are at risk of infection and malignant transformation ; therefore, complete resection is recommended. There is no indication for a surgical procedure or approach, but in our case, a large presacral epidermoid cyst with infection was resected using a transsacral approach.