VP03.06: Tailgut cyst: a curious incidental finding on gynecological ultrasound

Abstract

Tailgut cysts are rare congenital lesions that arise from primitive gut remnants that failed to regress during gestation. These are often misdiagnosed until middle age due to their anatomical position and variable clinical presentation. We report a case of a 32-year-old multiparous woman who presented for a pelvic floor ultrasound due to urinary incontinence symptoms. She was otherwise a healthy woman. Gynecologic examination was normal. In our unit, women referred for pelvic floor evaluation always include a transvaginal pelvic evaluation. Ultrasound showed a retroverted utero with signs of adenomyosis, no adnexal lesions, and also with signs of pelvic floor dysfunction. Between rectum posterior wall and sacrum, a multilocular lesion measuring 43x36x43 mm, with > 20 anechoic locules, colour score 2, apparently not fixed to rectum wall was found. A magnetic resonance also described a retrocecal left paramedian multicystic lesion, slightly bulging the posterior rectum wall but with no signs of parietal invasion, compatible with a tailgut cyst. The patient was referred to a colorectal pathology assistant for proper guidance. The diagnosis of tailgut cyst is difficult since ∼50% of patients are asymptomatic. Differential diagnosis is made with meningocele or epidermoid cysts, but usually these are unilocular lesions. Up to 13% of tailgut cysts undergo malignant transformation thus, surgical resection is usually indicated despite de absence of symptoms. This report emphasises the importance of a systematic and complete assessment of patients, as it may represent an opportunity to diagnose asymptomatic pathologies with malignant potential. regular 4/13 (30%) irregular 9/13 (70%) dishomogenous 12/13 (92%) omogenous 1/13 (8%) colour score 2: 4/13 (31%) colour score 3: 7/13 (54%) colour score 4: 2/13 (15%) present 4/13 (30%) absent 9/13 (70%) Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.