Tailgut cyst: from differential diagnosis to surgical resection—case report and literature review

Abstract

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.

Tailgut cyst: 2 case reports

“…The concern that retention of the coccyx will increase the risk of recurrence is not supported by published data, and some authors believe, if the cyst is not adherent to the coccyx and can be removed entirely without coccygectomy, that the coccyx should be left in place. 8 , 11 , 12 , 13 It is probable that the cyst itself, and not the coccyx, harbors the aberrant remnants of the postanal gut, leading to the formation of the cyst, and so coccygectomy carries no advantage if the cyst is not adherent to the coccyx. This perspective was adopted in the present series, with most surgeons electing to preserve the coccyx, unless en bloc resection was required for malignancy or the cyst was densely adherent to the coccyx.…”

Isolated lumbar intradural tailgut cyst: A case report and review of the literature

“…Due to the rarity of this malformation, real epidemiological data are difficult to obtain since only case reports and small case series are described in the literature [ 12 ]. In general tailgut cysts become clinically evident by the fifth decade, showing a marked female preponderance with a 3:1 ratio [ 13 , 14 ]. However, this condition has also been described in infants and in the fetus, strengthening the theory of a congenital origin [ 15 ].…”

Recurrent retrorectal tailgut cyst mimicking deep pelvic abscess: A diagnostic dilemma

“…Tailgut cysts are rare congenital malformations occurring in the presacral space [1] . The presacral space is bound by the fascia propria of the rectum anteriorly, the presacral fascia posteriorly, peritoneal reflection superiorly, rectosacral fascia inferiorly, and the internal iliac vessels, sacral nerve roots, pyriformis muscle, and ureters laterally [ 2 , 3 ]. Primitive endodermal remnants from the primitive hindgut beyond the cloacal membrane, which fail to regress in the embryonic life, form tailgut cysts [4] .…”

“…Symptoms are due to mass effect on adjacent organs such as polyuria, dysuria, pain on defecation and intercourse, rectal fullness, constipation, and low back ache. Long standing cases may rarely develop malignancy [ 2 , 5 ]. If infected, these may mimic pelvic abscess.…”