Laparoscopic transabdominal excision of presacral cyst shows no recurrence at 3 months in case report

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Frontiers in Medicine Published June 4, 2026 Medically reviewed June 4, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider laparoscopic transabdominal excision for presacral cysts in selected patients, but long-term data are lacking.

This is a case report combined with a narrative mini-review, focusing on the feasibility and safety of a laparoscopic transabdominal approach for radical excision of presacral cysts. The patient was a 39-year-old woman with a history of constipation and prior cesarean section. The procedure was performed by experienced surgeons, and at 3-month follow-up, the patient had no recurrence and no complications, recovering well.

The authors note that while the short-term results are encouraging, long-term follow-up is required to confirm recurrence outcomes. The mini-review context suggests that this approach may be feasible in selected patients, but the evidence is limited to a single case.

Limitations include the lack of long-term data and the inherent constraints of a single case report. The practice relevance is that the laparoscopic transabdominal approach appears feasible for radical excision of low-lying presacral cysts in selected patients when performed by experienced surgeons, but feasibility and safety remain to be fully evaluated.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

BackgroundPresacral cysts are clinically rare, deeply located, and pose diagnostic challenges prior to surgery. Complete surgical resection is the primary treatment. Laparoscopic techniques offer minimally invasive advantages; however, the feasibility and safety of the transabdominal approach for low-lying cysts remain to be fully evaluated. Through this case report and narrative mini−review, this study aims to assess the technical characteristics and value of this approach.Clinical presentationA 39-year-old female patient, with a history of constipation, no other significant medical history, and a prior cesarean section, presented due to a presacral cystic mass discovered during a routine gynecological ultrasound. She reported no specific discomfort such as abdominal distension or pain. Contrast-enhanced abdominopelvic CT revealed a cystic, low-density lesion in the presacral region (approximately 8.3 cm × 6.2 cm, with a pre-contrast CT value of about 28 HU), showing no significant enhancement. Pelvic MRI demonstrated that the cystic lesion exhibited slightly low signal on T1-weighted images (T1WI), slightly high signal on T2-weighted images (T2WI), markedly high signal on diffusion-weighted imaging (DWI), and low signal on apparent diffusion coefficient (ADC) map. The superior pole of the cyst was at the level of the coccyx. Digital rectal examination revealed a soft mass posterolateral to the rectum. After multidisciplinary discussion and thorough communication with the patient, a laparoscopic exploration was decided upon. Intraoperatively, a well-defined cystic tumor was visualized posterior to the rectum and was completely resected. Postoperative pathological diagnosis confirmed a (presacral) epidermoid cyst. At the 3-month follow-up, the patient recovered well with no recurrence or complications.ConclusionThe laparoscopic transabdominal approach appears feasible for radical excision of low−lying presacral cysts in selected patients when performed by experienced surgeons. Long−term follow−up is required to confirm recurrence outcomes.