Presacral epidermoid: A rare case and meningocele mimick

Abstract

Epidermoid cysts of the presacral space are a rare congenital entity. They have mostly been reported among women. We report a case of a 28-year-old male presenting with chronic constipation wherein magnetic resonance imaging (MRI) was suggestive of an anterior sacral meningocele associated with an epidermoid. This patient underwent a laparotomy and total excision of the mass. The lesion turned out to be an epidermoid cyst without any intradural communication or associated meningocele. This report highlights the limitations of imaging while it accentuates the need to perform diffusion-weighted MRI sequences for all cystic tumors in this region and to choose the correct operative approach based on its exact location in the presacral space.