Retrorectal cystic hamartoma: an unusual cause of retention of urine.

etrorectal cystic hamartoma are rare tumors of developmental origin usually diagnosed as an incidental finding in adult patients. We present such a case in a 33-year-old lady who presented with acute retention of urine. Ultrasound abdomen showed a retrorectal cystic mass (15 x 10 cm), which, was confirmed on computerized tomography (CT) scan. Exploratory laparotomy via a lower midline incision revealed a tense cystic mass (15 x 10 cm) occupying the retrorectal region. Total excision of the mass was carried out. Histopathology revealed a cystic hamartoma lined with stratified squamous epithelium. Retrorectal cystic hamartomas (RHC) are rare tumors, which, as their name implies, occur posterior to the rectum in the presacral space. These have been reported infrequently under various names such as cyst of postanal gut cysts, tailgut cyst and myoepithelial hamartoma of the rectum. Most cases are found incidentally in adults although RHC have been described as early as 1 month old. A 33-year-old lady presented with acute retention of urine. She had a 5 year history of voiding difficulty and chronic constipation preceding the episode of acute retention. She had 2 children (8 and 6 years old); both were born through normal vaginal deliveries. There was no history of any other surgical intervention carried out in the past. Clinical examination showed a distended bladder for which she was catheterized. Per vaginum examination revealed a tense cystic mass situated posteriorly. Ultrasound abdomen showed a retrorectal cystic mass (15 x 10 cm) with bilateral mild hydroureteronephrosis, which was confirmed on CT scan (Figure 1). Exploratory laparotomy via a lower midline incision revealed a tense cystic mass (15 x 10 cm) occupying the retrorectal region. Total excision of the mass was carried out. Histopathology revealed a cystic hamartoma lined with stratified squamous epithelium. The patient made an uneventful recovery and has normal voiding at 2 years of follow up. A hamartoma is a tumor like malformation in which the mature tissues of a particular part of the body are arranged haphazardly usually with an excess of one of its components. Retrorectal hamartoma are rare tumors of Clinical Notes