子宮内膜症との鑑別を要し、腹腔鏡下に摘出した直腸後腔におけるDevelopmental cystの2例

抄録

Objective: Various developmental cysts arise in the retrorectal space because the 3 germ layers in this region are involved in fetal development. We encountered 2 patients with developmental cysts in the retrorectal space that were difficult to differentiate from an endometrial cyst before surgery; the cysts were laparoscopically diagnosed and treated.

Patients: Both patients had a medical history in which an endometrial cyst was suspected; however, when the intra-abdominal cavity was examined, no abnormal finding was observed, and the abdomen was closed. In both patients, the presence of endometrial cysts measuring 7 cm on the right side of the rectum were suspected on preoperative magnetic resonance imaging. On laparoscopy, cysts were present in the right posterior region of the rectum in the retroperitoneal space and were excised. Pathological examination identified cystic hamartomas and epidermoid cysts.

Conclusion: Complete excision is necessary because this lesion may lead to infection and conversion to malignancy. The procedure is performed in the deep extraperitoneal pelvic region, and requires corresponding knowledge and experience with gynecological malignancies; however, laparoscopic surgery may be feasible.