Retropubic parasymphyseal cyst: A rare entity.

Area of Science:

• Urology
• Radiology
• Oncology

Background:

• Parasymphyseal cysts are rare, often presenting in the subpubic region.
• Distinguishing these cysts from other pelvic masses like vulvar lesions or bone tumors is clinically important.

Observation:

• A 69-year-old multiparous female with metastatic small bowel neuroendocrine tumor presented with a retropubic parasymphyseal cyst.
• Imaging revealed encapsulation, absence of solid components or diffusion restriction, and communication with the pubic symphysis.
• Gallium-68-Dotatate PET/CT showed no abnormal activity, and MRI characteristics were consistent with known subpubic cysts.

Findings:

• The retropubic parasymphyseal cyst was accurately diagnosed through a combination of imaging modalities.
• Key diagnostic features included specific MRI signal characteristics and lack of radiotracer uptake on PET/CT.
• The cyst's communication with the pubic symphysis was a significant differentiating factor.

Implications:

• This case underscores the importance of considering rare cystic lesions in the pelvic region, especially in patients with a history of malignancy.
• Familiarity with the imaging features of parasymphyseal cysts can prevent misdiagnosis and unnecessary interventions.
• Advanced imaging techniques like MRI and PET/CT play a crucial role in the differential diagnosis of pelvic masses.