Promoting Laparoscopic Anterior Approach for a Very Low Presacral Primary Neuroendocrine Tumor Arising in a Tailgut Cyst

Abstract

Background: Tailgut cysts are rare congenital lesions that develop in the presacral space. As they can potentially conceal primary neuroendocrine tumors, surgical excision is suggested as the treatment of choice. However, specific management guidelines have yet to be developed. A posterior approach is usually preferred for cysts extending to the third sacral vertebral body. Conversely, a transabdominal approach is preferred for lesions extending upward to achieve an optimal view of the surgical field and avoid injuries. Case report: Here, we report a case of a 48-year-old man suffering from perianal pain and constipation. Digital rectal examination and magnetic resonance imaging revealed a presacral mass below the third sacral vertebral body. A laparoscopic transabdominal presacral tumor excision was performed. The final histological diagnosis was a rare primary neuroendocrine tumor arising from a tailgut cyst. The postoperative course was uneventful, and no signs of recurrence were observed at the six-month follow-up. Conclusions: This study may help establish more well-grounded recommendations for the surgical management of rectal tumors, demonstrating that the laparoscopic transabdominal technique is safe and feasible, even for lesions below the third sacral vertebral body. This approach provided an adequate view of the presacral space, facilitating the preservation of cyst integrity, which is essential in cases of malignant pathologies.

A neuroendocrine tumor arising in a tailgut cyst: Case report and literature review

“…The present case showed a NET arising from a tailgut cyst, which is extremely rare. To the best of our knowledge, in addition to our case, there are only 29 cases of neuroendocrine neoplasms that reported detailed information ( Table 1 ) [ 7 , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] ]. The majority of the cases are women (18 cases out of 29).…”

Diagnosis and treatment of retrorectal cystic hamartoma: clinical case

“…Di Nuzzo и соавт. было выполнено лапароскопическое удаление передним доступом с сохранением тазового сплетения без повреждения кисты, избегая повреждения прямой кишки [19]. Лапароскопическое вмешательство позволяет безопасно удалить опухоль, снижает риск кровотечений и травм и улучшает выздоровление [20,21].…”