Abstract
IntroductionRetro-rectal cystic hamartoma (tailgut cyst) is a rare congenital developmental lesion arising from post-natal primitive gut remnants in the retro-rectal space. The rarity of the lesion and its anatomical position usually leads to difficulty in diagnosis and surgical management. Complete surgical resection remains the cornerstone of treatment. A dozen or so surgical approaches have been described in the literature to date to make the operation as simple as possible, but the trans-rectal access route is extremely rarely reported and not well described. Here, we present a case that demonstrates the trans-rectal approach to a retro-rectal tumor is a feasible option in terms of surgical radicality, minimal invasiveness and safety for carefully selected patients with this rare type of retro-rectal cystic lesion.Case presentationA 29-year-old Caucasian woman was referred to our institution due to perineal pain extending to the right inguinal region. Her symptoms had been present for the last two months. She was first examined at her regional hospital for a suspected ruptured ovarian cyst; however, after consultation with a gynecologist and a computed tomography scan of her pelvis, a tumor in the retro-rectal space was discovered. Our patient was admitted to our hospital and when a pelvic magnetic resonance imaging study confirmed the diagnosis of the retro-rectal cystic formation, a complete extirpation of retro-rectal tumor fixed to the coccyx using trans-rectal approach was performed. The final pathological diagnosis was retro-rectal cystic hamartoma (tailgut cyst) with no evidence of malignancy. Her post-operative course was uneventful, and at four months after surgery our patient is symptom free with no evidence of recurrent or residual disease.ConclusionsTrans-rectal excision is feasible in terms of surgical radicality and is a simple to perform, minimally invasive and safe option, providing complete recovery for carefully selected patients with retro-rectal cystic hamartoma treated operatively.
Highlights
Retro-rectal cystic hamartoma is a rare congenital developmental lesion arising from post-natal primitive gut remnants in the retro-rectal space
Trans-rectal excision is feasible in terms of surgical radicality and is a simple to perform, minimally invasive and safe option, providing complete recovery for carefully selected patients with retro-rectal cystic hamartoma treated operatively
Retro-rectal cystic hamartoma, known as tailgut cyst, is an uncommon congenital developmental lesion arising from post-natal primitive gut remnants, generally located in the retro-rectal space [1,2]
Summary
The prognosis of surgical management depends on achieving complete surgical excision of the tailgut cyst with clear margins. Trans-rectal excision is feasible in term of surgical radicality and can be an easy to perform, minimally invasive and safe option, providing complete recovery for carefully selected patients with retro-rectal cystic hamartoma treated operationally. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions EK and NES examined and treated our patient, and analyzed and interpreted the data from our patient. Both authors read and approved the manuscript. Author details 1Center of Oncosurgery, Institute of Oncology, Vilnius University, Santariskiu Street 1, Vilnius LT-08660, Lithuania.
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