A Case of Epidermal Cyst in the Retrorectum Safely Resected by a Combined Laparoscopic Approach

The surgical indications and optimal approach for retrorectal tumors remain unclear due to their rarity and the anatomical complexity of the presacral space. We report the case of a 48-year-old man in whom a retrorectal mass was incidentally detected on abdominal and pelvic computed tomography. Magnetic resonance imaging demonstrated a cystic lesion measuring 32 × 12 × 20 mm, with low signal intensity on T1-weighted and high signal intensity on T2-weighted images. Given the difficulty of establishing a definitive diagnosis and the potential risk of infection or tumor seeding with biopsy, primary surgical resection was selected. A combined laparoscopic transabdominal and trans-sacral approach enabled precise dissection under enhanced visualization of the pelvic anatomy, ensuring safe and complete tumor excision. The patient's postoperative course was uneventful, and he remained recurrence-free at the 1-year follow-up. This case highlights the pivotal role of laparoscopy in facilitating the safe resection of retrorectal tumors.