Abstract
A case of Mullerian duct cyst resected through an abdomino-sacral approach was reported. An 8-year-old boy was admitted because of recurrent urinary tract infection. At one-year-old, he had undergone removal of Wilms tumor (stage II) at our institution. He was also operated upon for his hypospadia four times at the urology between 4- to 6-year-old. At the fourth operation, the left intra-abdominal testis was removed. It pathologically showed extremely premature testicular tissue. After these surgeries, he had been frequently suffered from episodes of urinary tract infection and consulted to our clinic again. Voiding cyst-uretero-gram, CT scan and MRI examination revealed a cystic mass (6 × 2 × 3 cm) between the bladder and rectum. Right undescended testis was pexied and the cyst was successfully removed through an abdomino-sacral approach. The post operative course was uneventful and urination was satisfactory. The testicular tissue biopsied contained only premature tissue. On Pathological examination, the cystic wall consisted of squamous epithelium at the surface, and had muscle layer at the most part of the cyst and endometrium-like tissue at the bottom, which were similar to vagina and uterus respectively. Since recurrence of urinary tract infection and malignant change are reported, complete resection is curative. A combination of abdominal and sacral approach was a useful access to the cyst for complete resection.
