J Korean Orthop Assoc.  2010 Feb;45(1):97-100. 10.4055/jkoa.2010.45.1.97.

Pilonidal Cysts Occurring in the Sacrococcygeal Region and that were Misdiagnosed as a Simple Abscess

• Hong CH
• Ryoo SM

• KMID: 2185602
• DOI: http://doi.org/10.4055/jkoa.2010.45.1.97

Abstract

A pilonidal cyst is known to be a recurrent infectious disease in the sacrococcygeal region and it usually affects adolescents and adults. It is often misdiagnosed as a simple abscess or a sebaceous cyst, so there are many patients with pilonidal cysts who have gone through several operations. Although many treatments for this malady have been reported, the principle treatment for pilonidal cysts is radical excision. We report here on two cases of pilonidal cyst and the patients were misdiagnosed as having a simple abscess. We planned to perform incision and drainage, but the lesions were finally diagnosed as pilonidal cysts and so we performed radical excision for the treatment. We also review the medical literature on abscesses that occur in the sacrococcygeal region in early adulthood.

Keyword

pilonidal cyst; simple abscess; sacrococcygeal region; radical excision

MeSH Terms

Abscess
Adolescent
Adult
Communicable Diseases
Drainage
Epidermal Cyst
Humans
Pilonidal Sinus
Sacrococcygeal Region

Figure

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  Figure 1 (A) T2WI sagittal view, an ovoid-shaped mass like lesion which is located in the subcutaneous fat layer, sacrum level is seen, which displays high signal intensity. (B) It displays iso-signal intensity at T1WI sagittal view. (C) It displays septal-like enhancement and central low signal intensity at Gd T1WI (However, it does not seem to invade the connected muscle and it is not seen the abnormal signal intensity at bone marrow, spinal canal and disc.).

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  Figure 2 When the patient visited hospital, pilonidal sinus was detected at 5 cm upper from the anus during the inspection.

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  Figure 3 (A) T2WI axial view, a high signal intensity mass-like lesion is seen at the posterior aspect of coccyx, which displays peripheral thin-walled rim. (B) T1WI view, it displays low signal intensity. (C) Gd T1WI, the peripheral thin-walled rim is enhanced well.

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  Figure 4 This is photographed after total stitch out followed the radical resection operation.

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