Tailgut cyst with adenocarcinoma transition

Abstract

Rationale: Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare. Patient concerns: A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day. Diagnosis: Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0–3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0–35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition. Interventions: The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well. Lessons: We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.

An Unusual Perianal Presentation of a Tailgut Cyst

“…Complete surgical excision followed by histopathological examination is a must to eliminate the risk of recurrence, hemorrhage, infection, compression, and malignant transformation [ 6 , 12 ]. Postsurgical adjuvant radiation therapy with or without chemotherapy is suggested in cases of malignancy to kill residual tumor cells, prevent metastasis, and improve patient prognosis [ 2 , 13 ].…”

Mucinous adenocarcinoma of a tailgut cyst

“…Postsurgical resection histopathology remains the “gold standard” to diagnose TGC. 8 In the patient presented, the diagnosis of mucinous adenocarcinoma of a tailgut cyst was made from the histology of the resected specimen. Microscopically, the lesions are usually multicystic and are lined by various epithelial cells commonly found in the adult and fetal gastrointestinal tract, including columnar, stratified columnar, transitional and squamous epithelia.…”

Adenocarcinoma in a Recurrent Retrorectal Cyst: A Case Report

“…Retrorectal cysts, also known as tailgut cysts or retrorectal cystic hamartomas, are developmental cysts that arise from the residue of the tailgut of the intestine during the embryonic period, 1 , 2 and are located in the retrorectal space. 3 The retrorectal space is found behind the rectum, in front of the sacrum, with the ureters, iliac blood vessels, sacral nerves, and lateral stalks of the rectum serving as its lateral walls, which makes both the diagnosis and surgical approaches used to address these lesions difficult.…”

“…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.…”

“…12,13 Diagnosis is usually performed using computed tomography (CT), magnetic resonance imaging (MRI), biochemical analysis, and histological findings following excision. 1 Radiological tests are essential in differentiating between benign and malignant lesions; however, a definitive diagnosis is supported by surgical and histological findings. 12 Neither fine-needle aspirate nor ultrasound-guided biopsy is recommended, as these procedures may lead to complications that include the formation of fistulae and may lead to the potential spread of malignant cells, if present.…”