Rectal duplication in an adult: Unusual cause of a buttock mass - Report of a case

PURPOSE: Duplications of the rectum are extremely rare embryologic events, with almost 70 cases reported in the world literature. We report on a 39-ye ar-old female patient with a duplication of the rectum. METHODS: Physical e xamination showed a left buttock mass; rectal examination revealed the pres ence of a painless mass compressing the rectum posterolaterally, confirmed by computerized tomography. RESULTS: The patient was operated on with a abd ominal then a sacrococcygeal approach. After a complete excision, the posto perative course was unremarkable. Histology revealed a rectal duplication l ined with heterotopic cylindric ciliated epithelium. DISCUSSION: This case shows that the diagnosis of rectal duplication is difficult and can be conf used with other types of anorectal pathology. The presence of heterotopic c iliated epithelium has rarely been described. Complete excision of the dupl ication should be possible in most cases using a transcoccygeal, transanal, or abdominoperineal approach, depending on anatomic considerations.