Tailgut cyst adenocarcinoma

Abstract

Tailgut cysts (TGCs) are rare congenital entities arising from remnants of the embryological postanal primitive gut. Malignancy in TGCs is rare, with the majority being adenocarcinomas and carcinoid tumors. A search of the published literature yielded only 27 cases of adenocarcinoma developing in TGCs. We described the case of a 54-year-old female who presented with complaints of pelvic and perineal pain of several weeks. After the initial work-up, a mass in the right presacral location was diagnosed. She underwent radical resection of the tumor, using a posterior approach. The lesion was removed en bloc with the middle rectum, coccyx, and sacrum (S4-S5). The histopathologic examination revealed an adenocarcinoma arising in a TGC, and the patient received adjuvant chemoradiotherapy. Our case underlines that diagnosing a TGC is difficult as it is a rare congenital lesion. Clinical examination may be challenging as TGCs present with various symptoms, which can mimic other commonly proctologic disorders. Patients should be referred to a tertiary center with experience in pelvic surgery and must be managed by a multidisciplinary approach to maximize successful treatment. The recommended treatment is surgical excision given the malignant potential of TGCs and their risk of causing local complications.

Adenocarcinoma in a Recurrent Retrorectal Cyst: A Case Report

“… 2 Furthermore, where aspiration has been performed and the cysts has been deemed operable, it is important to resect the biopsy tract during surgery. 10 Cyst aspiration in this patient possibly led to the formation of fistulas and abscesses, and potentially resulted in the spread of malignant cells.…”

“… 9 Affected patients may also present with varied symptoms that can mimic other proctological disorders. 10 In the literature, cases presenting with lower back pain have been reported. 11 Tailgut cysts are usually benign, but can undergo malignant transformation.…”

“…Excision also prevents recurrent drainage. 1 , 9 , 10 Where there is malignant transformation, resection and chemotherapy are usually recommended. Other supplemental therapy includes adjuvant radiotherapy.…”

Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review

“…30,31 However, the rarity of the disease along with atypical presentation contribute to a delayed diagnosis, constituting TGCs' cases a diagnostic challenge for the physicians. 23 The incidence of malignant degeneration of TGCs differs among published studies in the literature. 32,33 Hjermstad et al 34 an increased occurrence of tumours arising in TGCs.…”

Zufallsbefund eines intestinal differenzierten Adenokarzinoms in einer Tailgut Zyste nach robotisch-assistierter Resektion

“…Häufig werden diese Befunde zufällig im Rahmen einer Bildgebung entdeckt. Sie können aber auch durch unspezifische gastrointestinale Symptome, Schmerzen oder Stuhlunregelmäßigkeiten durch das verdrängende Wachstum der Zysten auffallen [5][6][7].…”