Presacral developmental cysts in mother and daughter

Summary and Conclusions Developmental cysts, both epidermoid, were found in a woman and her daughter. Although a familial tendency has been ascribed to epidermoid cysts, insofar as we have been able to determine the two cases which we have reported are the first in the medical literature to substantiate this impression. Incidence, classification, pathology, etiology, symptoms, diagnosis, and treatment of developmental cysts have been reviewed. Developmental cysts include dermoid cysts, epidermoid cysts, and mucous cysts. They must not be confused with teratomas, which are true tumors. Developmental cysts are derived from cell rests that remain during the complex development of the caudal portion of the embryo, and they vary with the types of tissue elements represented. Treatment of developmental cysts before infection occurs consists of simple excision, which is usually complete and results in cure. This was exemplified in the treatment of the daughter (Patient 2). However, the problem becomes complex after infection occurs, and unless the lesion is suspected initially, that is, at the time an abscess is first opened, continued infection after repeated operations may result in such disability that the ultimate in radical surgery—an abdominoperineal resection—may be necessary. This happened in the mother (Patient 1).