Tailgut cyst is a rare tumor originating from the embryonic remnant located in the retrorectal space. The diagnosis is usually incidental duse to the absence of symptoms. When present, they are nonspecific, such as abdominal pain, dysuria and tenesmus. Imaging tests are a great help in the diagnosis and surgical planning. The standard treatment is resection, which the surgeon must perform to avoid future complications, such as malignancy. We present a case of tailgut cyst in a young patient with prior pilonidal cyst excision, subsequently submitted to surgical resection, to share our experience with a rare case, with few reports in the literature.

BackgroundAcute appendicitis is the most common surgical emergency in daily practice, and is approached laparoscopically in many centers. Efforts have been undertaken for the development of minimally invasive techniques that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS).AimTo present a minimally invasive technique for appendectomy (SILS) undertaken with conventional instruments.MethodEleven patients were treated in the emergency care center presenting abdominal pain in the right iliac fossa that was suggestive of appendicitis. Diagnostic investigation was subsequently conducted, including physical examination, laboratory and imaging exams (CT scan with intravenous contrast or total abdominal ultrasound), and the results were consistent with acute appendicitis. Thus, after consent, these patients underwent SILS appendectomy under general anesthesia with three trocars (two 10 mm and one 5 mm), using conventional and optical laparoscopic tweezers (10 mm, 30º). The base and pedicle of the appendix were ligated with titanium LT 400 clips. The procedure occurred uneventfully. Inclusion criteria were absence of diffuse peritonitis, BMI (body mass index) less than 35 and absence of serious comorbidities or sepsis.ResultsSeven men and four women were operated with average age of 25.7 years and underwent appendectomy through this technique. Mean procedure duration was of 37.2 min. Regarding surgical findings, three had appendicitis in stage 1, four in stage 2 and four in stage 3. All patients improved well, without surgical complications, and did not require conversion to open surgery or conventional laparoscopy technique.ConclusionAppendectomy conducted through Single Incision Laparoscopic Surgery is a feasible and promising technique that can be performed with conventional laparoscopic instruments.

O fibrossarcoma epitelióide esclerosante (FEE) pode ser conceituado como uma neoplasia maligna constituída por ninhos e cordões de pequenas células arredondadas, poligonais e ovóides, de citoplasma claro e escasso, hialinização exuberante e alto grau de esclerose. Compromete mais freqüentemente extremidades, tronco e pescoço. O FEE é considerado um sarcoma de baixo grau e demonstra imunorreatividade ao P 53, sugerindo um papel de destaque deste fator. A recorrência local está relacionada com a ressecção com margem de segurança insuficiente. O diagnóstico diferencial é vasto e inclui tumores e proliferações fibrosas, como fasciíte nodular, miosite ossificante, desmóides, leiomioma hialinizante e histiocitoma fibroso, fibrossarcoma sinovial, sarcoma de células claras de tendões e aponeuroses, osteosarcoma de pequenas células, rabdomiosarcoma alveolar. Os tumores localizados no tronco, as lesões volumosas e em homens comprometem o diagnóstico.Os autores relatam um caso de um paciente de 44 anos, com tumoração localizada em face ântero-medial do braço direito, com evolução em 3 meses, cuja biópsia incisional revelou tratar-se de FEE. Serão discutidos aspectos anatomopatológicos, quadro clínico e tratamento instituído para o caso.