Benign ectopic prostate-a rare differential for a presacral mass

Area of Science:

• Colorectal Surgery
• Pelvic Anatomy
• Histopathology

Background:

• Chronic perianal pain and urinary incontinence can stem from various pelvic pathologies.
• Presacral masses are uncommon and require thorough investigation to determine their origin.

Purpose of the Study:

• To report a unique case of benign ectopic prostate presenting as a presacral mass.
• To discuss the diagnostic challenges and surgical management of such rare pelvic lesions.

Main Methods:

• Clinical presentation of a middle-aged male with chronic pelvic symptoms.
• Pelvic MRI to characterize the presacral lesion.
• Surgical excision and histopathological examination of the mass.

Main Results:

• A tender retro-rectal mass was identified, confirmed by MRI as a cystic lesion in the presacral region.
• Surgical excision revealed a benign ectopic prostate.
• Histopathology confirmed the presence of muscular stroma and bilayered glandular epithelium.

Conclusions:

• Benign ectopic prostate can manifest as a presacral mass, mimicking other cystic lesions.
• Surgical excision is curative, and histopathology is crucial for definitive diagnosis.
• This case expands the differential diagnosis for presacral masses presenting with chronic pelvic pain.