Tailgut Cyst: a Case Report in a Female Neonate

Abstract

Tailgut cyst, or retrorectal cystic hamartoma, is a rare congenital lesion found in the presacral space. The lesion has been infrequently reported in the literature. We report a 16 days female neonate presented with urine retention. the retrorectal or presacral space (4) and rarely in the perirenal area (2,3,5), the subcutaneous tissue in the anorectal region (6) and more rarely in the prerectal location. Microscopically, the tailgut cyst is characterized by the presence of a cysts lined with varying types of epithelium; columnar, mucin secreting epithelium predominates, while other areas of squamous and transitional epithelium often coexist (7). The differential diagnosis of cystic masses in this space includes sacrococcygeal teratoma, dermoid cysts and other complex ovarian masses, rectal duplication cysts, anterior meningoceles, cystic lymphangiomas and abscesses (8,9). There is an approximately 3:1 female preponderance of cases reported (4). Uncomplicated lesions are typically asymptomatic, and patients usually come to medical attention when the cyst becomes infected or when the lesion is incidentally discovered either radiologically or during physical examination. Perineal pain, pain with defecation, painless rectal bleeding, urinary frequency, and change in stool caliber have been reported. A few rare cases of malignant change associated with a tailgut cyst have been reported, but none in children to our knowledge (4,10,11). Few cases have been reported in children. The largest series by Hjermstad and Helwig (4) at the Armed Forces Institute of Pathology describes 53 cases of the entity collected during a 35-year period. Five cases demonstrating the CT and sonographic findings of tailgut cysts were described by Johnson et al. (12) at the Armed Forces Institute of Pathology. There are only a handful of reports of the MR findings of this entity in adults and only a few cases in the pediatric population (13).