Clinical Misdiagnosis of Anterior Sacral Cyst and Literature Review

CHEN Renkai; TAN Zhaoyang; MO Li; YIN Huiming

doi:10.3969/j.issn.1002-3429.2025.05.002

Abstract：Objective To explore the causes of misdiagnosis of anterior sacral cyst and the preventive measures.Methods The diagnosis and treatment of a case of anterior sacral cyst misdiagnosed as endometriosis admitted to hospital in January 2024 were analyzed,and the causes of misdiagnosis were analyzed according to relevant literature.Results The main symptoms of this 45-year-old female patient were menstrual disorder with dull pain in the left lower abdomen,which had no obvious relationship with menstrual cycle,frequent regular bowel movements,pelvic CT examination indicating multiple cystic lesions in bilateral accessory areas and fluid and blood accumulation in perirectal space,and no special laboratory exam-ination indicators.Misdiagnosed as endometriosis,laparoscopic resection of pelvic lesion,retroperitoneal mass aspiration and subcutaneous injection of leuprelin acetate sustained release microspheres were not effective.Two months later,she was trea-ted for cholecystolithiasis with cholecystitis.The MRI examination was completed and the anterior sacral cyst was considered.After surgical pathological examination,the diagnosis was confirmed as caudal intestinal cyst,and the misdiagnosis time was 2 months.There was no recurrence after half a year follow-up.Conclusion Presacral cyst is rare in clinic,the symptoms lack specificity,early diagnosis is difficult,and easy to be confused with other diseases.Clinicians should strengthen their under-standing of the disease,inquire about the patient s history in detail,conduct a thorough physical examination and multidiscipli-nary consultation,and improve MRI and other imaging examinations as soon as possible to fully evaluate the condition,which can effectively avoid the occurrence of misdiagnosis.