Benign retrorectal tumors in adults: the choice of operative approach

Six adult patients were treated for tumors of the retrorectal space from 1975 to 1990 at the University of Mississippi Medical Center. All were female; ages ranged from 19 to 64 (mean, 37.8) years. Two asymptomatic tumors were discovered in the peripartum period, and two patients had symptoms of local fullness or pain. One patient presented with a pelvic abscess, and one patient had had recurrent pilonidal cyst abscesses drained. All lesions were completely excised (one by a transsacral route, two by a transanal route, and three by a combined abdominosacral approach). All were histologically benign (four tailgut cysts and two epidermoid cysts). One tailgut cyst recurred after transanal excision and was removed by a transsacral route without further recurrence. Adequate excision may be achieved by any of several approaches. Transanal excision, although convenient for small low-lying dermoid tumors, resulted in the only recurrence in our series.