Anterior sacral meningocele differential diagnosis

• Severe onset of inflammatory myositis in a child: think to paraneoplastic myositis
• Rare presentation of rectal duplication cyst as perineal hernia in an adult
• An Unusual Presentation as Recurrent Abortions in a Case of Giant Presacral Epidermoid Cyst Mimicking an Anterior Sacral Meningocele
• Rupture of Giant Anterior Sacral Meningocele in a Patient with Marfan Syndrome: Diagnosis and Management
• Congenital talipes equinovarus and congenital vertical talus secondary to sacral agenesis
• Differential diagnosis of anterior sacral meningocele during the evaluation of post-hysterectomy pelvic collections
• Anterior Sacral Meningocele Masquerading as an Ovarian Cyst: A Rare Clinical Presentation Associated with Marfan Syndrome
• A neonate with deformities of the bilateral lower extremities and bowel and urinary incontinence

Anterior sacral meningocele should be considered in the differential diagnosis of cases with pelvic cysts, particularly in patients with underlying connective tissue disorders. Because severe neurologic complications or even death may occur without proper preoperative planning in such cases, MR imaging should always be performed for evaluation and characterization of pelvis cystic lesions ¹⁾.

The differential diagnosis of ASM includes cystic lesions located in the presacral region: tumors of the gastrointestinal or genitourinary tract; epidermoid or dermoid cysts; aneurysmal bone cyst; hamartoma; hydatid cyst; lipoma; lymphangioma; perineural cyst; rectal duplication cyst; gynecologic tumors; teratoma; or teratocarcinoma. The most important means of establishing the definitive diagnosis is detecting communication between the cystic lesion and the subarachnoid space ²⁾.

Good clinical examination and radiological investigations should be able to differentiate ASM from other causes of cystic presacral masses in children which include

Tailgut duplication cyst

Presacral Neurenteric Cyst

a) sacrococcygeal teratoma (Altman type 4);

b) tumors like dermoid, lipomas, and neuroblastoma;

c) neuroectodermal cyst;

d) rectal duplication cyst;

e) ovarian cyst

f) pelvic kidney

Presacral Epidermoid Cyst ³⁾.