Histopathological diagnostic dilemma in retrorectal developmental cysts: report of a case and review of the literature

Abstract

Retrorectal developmental cysts are lesions that are classified according to their histopathological characteristics and origins. The major types are epidermoid cyst, dermoid cyst, rectal duplication cyst, rectal cystic hamartoma and teratoma. These cysts grow slowly and the majority of cases are asymptomatic. Total excision is required and histopathological examination should be carefully performed for retrorectal localized developmental cysts, since the cystic lesions may show malignant transformation. Here, a 3-year-old male patient with retrorectal mass, which was histopathologically compatible with tailgut cyst, is presented and the differential diagnosis of retrorectal developmental cysts is discussed.

Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature

“…The eligible papers and Table give a good impression of the typical case. The relative risk for malignant transformation was raised in the case of finding nodular thickening of the cyst wall on radiology ( P = 0.0023).…”

Tailgut Cysts with Malignant Transformation: Features, Diagnosis, and Treatment

“…In the macroscopic view, posterior rectal cyst specimens have mucosal characteristics such as a white or pink color, smooth in appearance on one side, and irregular appearance on the other side. Microscopically, the whole intestinal wall is connected with loose fibrous tissue on one side and the cystic mass closes to the intestinal wall [46]. In most cases, simple tailgut cysts are not evaluated using immunohistochemistry, possibly because the components of cysts are relatively simple and the clinical significance of immunohistochemistry is not obvious.…”

An unusual rectal duplication cyst

“…Retrorectal developmental cysts are lesions that can be categorised according to their histopathological features and origins. The commonest kinds are the epidermoid cyst, dermoid cyst, rectal duplication cyst, rectal cystic hamartoma and teratoma [3]. Regarding their embryogenesis, there are two theories more dominant: (a) the Veeneklass theory that supports a malseparation of the notochord which explains the gastric epithelium and (b) the Lewis-Thyng theory that is less accepted and supports a diverticula existence on the 8–9 weeks foetus [13, 14].…”

“…Duplicate rectal cysts are the least common between the gastrointestinal congenital cysts, forming only 4% of them [1], and they are known to derive from the hindgut [2]. They are described as congenital/developmental tumours of the presacral space, and they are spherical and tubular structures, connected firmly to the intestines [3]. Although they are mostly asymptomatic, patients with duplicate rectal cysts can present with a rectal mass, constipation, pressure effects, tenesmus, or even urinary retention [4].…”