Management of tailgut cysts in a tertiary referral centre: a 10‐year experience

Patsouras, Dimitrios; Pawa, Nikhil; Osmani, Humza; Phillips, R. K. S.

doi:10.1111/codi.12919

Cited by 57 publications

(105 citation statements)

References 27 publications

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“…The retrorectal region is a potential space that may develop in the presence of a mass which is delimited superiorly by pelvic peritoneal reflection, inferiorly by the coccygeal and elevator muscles of the anus, anteriorly by the rectum, posteriorly by the sacrum and the coccyx and laterally by the iliac vessels, and ureters [1,2,4]. The differential diagnosis of masses that can develop in this area is vast and includes primary tumors of neurogenic, osteogenic and congenital origin, and inflammatory and metastatic secondary processes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Retrorectal cystic hamartoma: A case report

Viveiros¹,

Cruz²,

Gouveia³

et al. 2017

Case Rep Int

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Section: Discussionmentioning

confidence: 99%

“…The congenital conditions include teratoma, chordoma, sacred anterior meningocele and cystic lesions (dermoid, epidermoid, hamartomas, etc.) [1]. Retrorectal hamartomas are congenital lesions that appear as an embryonic remainder of the large intestine (hindgut) and which are usually located in the pre-sacred space.…”

Section: Introductionmentioning

confidence: 99%

Retrorectal cystic hamartoma: A case report

Viveiros¹,

Cruz²,

Gouveia³

et al. 2017

Case Rep Int

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“…Many surgeons would agree that presacral tumors extending above the body of S3 may need a combined abdomino-perineal approach during excision. [13,14] Also, the level at which the median sacral artery can be secured by ligation (to guard against bleeding complications during excision of the mass) was found to shift upwards with deeper tumor extension. Exposure of the artery is usually performed from below after separation of the coccyx.…”

Section: Deep Extension Of the Tumormentioning

confidence: 99%

“…The near-by vertebral column is an important anatomical landmark that can be used as a scale to measure the exact degree of tumor extension in relation to the bodies of the corresponding vertebrae. SCTs with deep extension (above the body of S3) may require a combined abdomino-perineal approach for excision [13,14]; moreover, they have been found to cause marked compression and distortion to surrounding pelvic structures. In such situations, careful dissection and proper reconstruction of the pelvic musculature after tumor excision is crucial for preservation (as much as possible) of the functional potential in these patients.…”

Section: Both Were Malignantmentioning

confidence: 99%

Preoperative Grading of Sacrococcygeal Teratoma: A Roadmap to Successful Resection

AbouZeid¹,

Mohammad²,

Elsherbeny³

et al. 2017

J Neonat Surg

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACTPurpose: to include the most relevant preoperative imaging features of sacrococcygeal teratoma (SCT) in a grading system that would provide guidance to surgeons during excision of such rare tumors.Patients and Methods: The medical records of patients with SCT, who were managed at our hospital during the period 2009 through 2016, were retrospectively reviewed. Only cases of SCT with available preoperative cross-sectional imaging studies (MRI and/or CT scans) were included in the study. The preoperative imaging features were correlated to the operative and pathological findings.Results: The study included 24 cases of SCT (20 females and 4 males). Their age at presentation ranged from day one to 36 months. The following were identified as relevant preoperative imaging features to be included in our proposed grading system: tumor size, level of deep extension of the tumor, and tumor consistency. Among predominantly cystic SCT, a special subtype C3 could be identified with its characteristic irregular internal cyst wall thickening caused by the in-growth of solid tumor component. These cases were always associated with immature pathology.Conclusion: MRI is a useful modality in the preoperative assessment of cases of SCT by providing a grading system that can indicate for the prognosis and degree of expected surgical challenge.

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“…When deciding on a surgical approach in perirectal tumor resection, the operator should always consider the possibility of damage to the ureter, adjacent nerves, and neighboring organs. En bloc resection without damage to the cyst during surgery should be performed with adequate preoperative assessment, even though the rate of malignancy is low [8,9].…”

mentioning

confidence: 99%

Tailgut Cyst, Report of 24 Cases Single Center Experience

Kwak

Kim

2019

Ann Coloproctol

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Retrorectal tumor was first described in a case report in 1885 [1] and, according to the Mayo Clinic, is very rare, with a frequency of 1 in 40,000 patients [2]. The United States Armed Forces Institute of Pathology has published 53 cases over 35 years, showing that the condition is predominant in females and causes inflammation in half of the patient population. Biopsies in most patients have confirmed remnants of the embryonic tailgut [3]. This tumor can be malignant and then requires preoperative evaluation or surgery. Another study that published 34 cases over 22 years reported a higher probability of malignancy in male patients, patients who had painful symptoms, and patients of advanced age [4].Sakr et al. [5] analyzed 24 patients who underwent surgery over 12 years; to the best of our knowledge, this is the first Korean case series. Similar to others, this study found that tumor occurrence was predominant in females, and that asymptomatic patients accounted for more than half of the total. The differences from previous studies were that tumor location was analyzed relative to the levator muscle, and that surgical approaches were classified as anterior with laparoscopy, posterior through the perineum, or a combined approach. Following this classification, the authors found the highest complication rate (P = 0.021) in the posterior group, and that a larger tumor size (P = 0.001) and more tumors located above the coccyx (P = 0.002) resulted in a higher rate of the combined approach.It is also noteworthy that 10 cases were laparoscopically resected, indicating a recent trend of laparoscopic abdominal surgery. Lap-aroscopic excision of perirectal tumors approximately 4 cm in diameter was first reported in Korea in 2011 at the S4 level [6]; more recently, larger-sized excision at lower levels has also been introduced [7]. As noted in this study, in cases of the anterior approach using laparoscopy, nerve damage could cause sexual dysfunction and pelvic dyssynergia. Based on the author's experience, in cases of anterior laparoscopic approach, camera access is difficult due to a narrow pelvis during distal marginal ligation of the tumor. As a result, the structure around the pelvic floor is not clearly identified, which may result in injury to the pelvic muscle or the cyst itself. On the other hand, in cases of posterior perineal resection, damage to the anal sphincter is possible and demarcation of the cyst can be difficult because the proximal margin of the tumor is not identified. In such cases, as in this study, it is believed that the combined approach can compensate for the disadvantages of each approach. When deciding on a surgical approach in perirectal tumor resection, the operator should always consider the possibility of damage to the ureter, adjacent nerves, and neighboring organs. En bloc resection without damage to the cyst during surgery should be performed with adequate preoperative assessment, even though the rate of malignancy is low [8,9]. CONFLICT OF INTERESTNo potential conflicts of interest re...

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Management of tailgut cysts in a tertiary referral centre: a 10‐year experience

Abstract: Tailgut cysts are an uncommon yet important cause of chronic perianal sepsis. Suspicion should be raised in a patient, usually female, presenting with a history of unsuccessful procedures. Diagnosis can be made by clinical assessment and MRI. Complete excision usually resolves the problem.

Cited by 57 publications

References 27 publications

Retrorectal cystic hamartoma: A case report

Retrorectal cystic hamartoma: A case report

Preoperative Grading of Sacrococcygeal Teratoma: A Roadmap to Successful Resection

Tailgut Cyst, Report of 24 Cases Single Center Experience

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