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Case Report
 
Retrorectal cystic hamartoma: A case report
 
Ricardo Cabrita Viveiros1, José Pinto Cruz2, Rubina Lara Gouveia2, Ricardo Jorge Pestana3, Jorge Miguel Fernandes4, Maria José Olim1
 
1MD, Hospital Dr. Nélio Mendonça, Resident, General Surgery, Funchal, Madeira, Portugal.
2MD, Hospital Dr. Nélio Mendonça, Consultant, General Surgery, Funchal, Madeira, Portugal.
3MD, Hospital Dr. Nélio Mendonça, Consultant, Neurosurgery, Funchal, Madeira, Portuga.
4MD, Hospital Dr. Nélio Mendonça, Fellow, General Surgery, Funchal, Madeira, Portugal.

Article ID: 100033CRINTRV2017
doi:10.5348/crint-2017-33-CR-2

Address correspondence to:
Ricardo Nuno Cabrita Viveiros
Travessa Manuel Alexandre, n° 7b
Funchal, Madeira
Portugal

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How to cite this article
Viveiros RC, Cruz JP, Gouveia RL, Pestana RJ, Fernandes JM, Olim MJ. Retrorectal cystic hamartoma: A case report. Case Rep Int 2017;6:5–8.


Abstract
Introduction: Retrorectal hamartomas are congenital lesions that typically present themselves as pre-sacred tumor masses. Clinical manifestations are light and highly variable at presentation time, often leading to diagnostic difficulties and surgical failure.
Case Report: A case of 46-year-old female who is referred to neurosurgery by her medical assistant with a few months history of paresthesia and decreased left lower limb muscle strength and more recently symptoms of gastrointestinal disorders (constipation, tenesmus and feeling of false wills). Imaging studies revealed a pre-sacral tumor with suspicion of nerve dependence on S4 and cystic nature. She underwent partial resection of the capsule of the lesion and aspiration of its contents by multidisciplinary team abdominal approach (general surgery/neurosurgery). The anatomopathological examination revealed a retrorectal cystic hamartoma. During follow-up the patient again developed tenesmus, false desires and the paresthesias of the left leg reappeared. The imaging tests confirmed a recurrence of the retrorectal hamartoma. The patient was again operated for block excision, this time by posterior approach.
Conclusion: This case highlights the importance of retrorectal hamartomas as a differential diagnosis of presacral masses and it shows the difficulty in obtaining its diagnosis and treatment.

Keywords: Presacral space, Retrorectal cystic hamartoma, Tailgut cyst


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Author Contributions
Ricardo Cabrita Viveiros – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published.
José Pinto Cruz – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published.
Rubina Lara Gouveia – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ricardo Jorge Pestana – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published.
Jorge Miguel Fernandes – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published.
Maria José Olim – Analysis and interpretation of data, Drafting the article, Drafting the article, Final approval of the version to be published.
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Ricardo Cabrita Viveiros et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.