Presacral cysts in children

Presacral epidermal cyst is a rare congenital formation in pediatric practice of ectodermal origin, from ectodermal remnants of tissues that are displaced during embryogenesis due to the development of surrounding structures. In general, presacral dermoid cysts make up less than 5% of all tumor-like formations of the presacral space. Presacral formations can have a nervous, vascular/lymphatic, mesenchymal or mixed (like medulloepithelioma) origin, they can be primary (in focal diseases) or systemic (in multifocal diseases). Presacral cysts are often encountered as incidental findings, due to their unusual localization and slow growth, which ensures their long asymptomatic course. The painful symptom is usually associated with secondary infection and malignant transformation. The aim is to highlight the experience of diagnosis and treatment of presacral cysts based on literature sources and own experience. Presacral cysts in children are a rare pathology that requires significant diagnostic efforts in terms of visualization and differential diagnosis. Treatment of presacral cysts in childhood should be only operative, consisting in extirpation of the formation with mandatory morphological verification of the final diagnosis. The choice of operative approach for the extirpation of presacral cysts should take into account the data of visualization methods of the localization of formations in the presacral space, taking into account the height of their proximal pole to prevent possible perioperative complications. As far as possible, extirpation of cysts should take place as sparingly as possible, in order to prevent damage to their walls and the possibility of probable insemination by totipotent cells of the presacral space and prevention of recurrences of the pathology. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child's parents was obtained for the research. The authors declare no conflict of interest.