Retrorectal cyst

Retrorectal masses are a rare, heterogeneous group of tumors. High index of suspicion and early diagnosis is important for prompt treatment, and avoiding early complications such as infection and malignant transformation. A thorough history and physical exam including digital rectal exam along with proctoscopy or endorectal ultrasound, CAT scan and/or MRI is often sufficient for preoperative planning. All retrorectal masses should be excised surgically, unless there is high suspicion of a chemosensitive tumor, or the lesion is unresectable. Avoid preoperative biopsy of cystic lesions, and do not biopsy via rectum or vagina to avoid infectious complications. Choosing the proper operative approach based on the tumor location and characteristics will enable the best access to the tumor, and the safest procedure. Complications range from bleeding, infection, rectal injury, recurrence, and neurologic sequelae. Careful attention to surrounding structures, access to vascular control, preoperative bowel preparation, and complete microscopic R-0 excision when possible can help to minimize these complications.