Rectal Duplication Cyst Research Articles

Anorectal hamartoma in a neonate: a unique anorectal mass

Neonates presenting with perineal masses are uncommon. When encountered, most perineal masses are anorectal malformations, sacrococcygeal teratomas, rectal prolapse, or duplication cysts. We present an otherwise healthy newborn with a patent anal canal and a pedunculated anal mass. The mass was initially believed to be a prolapsed rectal duplication cyst. Further evaluation for concomitant congenital abnormalities was negative. The patient underwent mass excision at the bedside under local anesthesia. Histopathologic evaluation revealed benign hamartoma. This case is presented because of its rarity, unique presentation, and simplicity of management.

Rectal duplication cyst: a combined abdominal and endoanal operative approach

Rectal duplication cysts are rare, comprising <5% of all gastrointestinal duplications. Early excision is the treatment of choice and a number of surgical approaches have been described. We present a 3-week-old infant with a 3 cm cyst that was excised using a previously unreported combined abdominal and endoanal approach.

Tailgut cysts: diagnostic challenge for both pathologists and clinicians

Retrorectal area is a well-known space for the presence of some familiar lesions, like “sacrococcygeal teratoma” in children and a low-grade malignant tumor called “chordoma” in adults. However, a variety of congenital, inflammatory, and neoplastic lesions can occur in this area, but not famous enough to the practicing pathologist to be easily familiar with. Retrorectal cystic hamartoma or “tailgut cyst” is one of them. It is a benign, developmental lesion. In addition to its nonspecific and misleading clinical presentation, it can also confuse the pathologist while giving the definitive diagnosis. Patients who had multiple, unnecessary operations before the correct diagnosis was made had been reported in the literature. The largest series of 53 cases was collected over a 35-year period by Hjermstad and Helwig at the Armed Forces Institute of Pathology, Washington, DC, USA. Unfortunately, 51 out of 53 cases were not given the correct initial diagnosis of tailgut cyst. However, most of the pathologists were aware of that they were dealing with a benign, congenital, cystic process but had difficulty in further classifying it. A 37-year-old Turkish woman was admitted to our hospital with 3 months history of weakness in her legs with an accompanying low back pain. Her medical history included an appendectomy performed approximately 20 years ago and two cesarean sections. The transrectal ultrasound showed a well-defined cystic mass with dense internal echoes in the posterior rectal area, measuring 3.5×2.5 cm. Partial, minimal lobulation was identified in its posterior part. MRI revealed a well-circumscribed cystic lesion in the presacral area at the level of lower sacrum and coccyx. Another hypodense anococcygeal cyst was also identified. The left half of the sacrum showed hypoplasia. The patient had undergone an operation with the preoperative diagnosis of rectal duplication cyst based on the radiological findings. Both cysts were excised completely. Frozen section just revealed a benign simple cyst. Gross examination showed that both cysts are thin-walled and the larger one measures 3 cm in its maximum diameter. Cyst fluid was clear in appearance. Microscopically, different types of epithelium were identified lining the cyst walls. The cysts are mostly composed of stratified squamous epithelium and ciliated columnar epithelium, but low cuboidal to flat epithelium was also present. Fibrofatty tissue was seen in the underlying stroma with accompanying focal, mild mononuclear inflammatory cell infiltrate. No remarkable specific tissue fragments were identified in the wall, like bundles of well-formed smooth muscle fibers, adnexal elements of the skin, neural elements, and heterologous mesenchymal tissue, like cartilage or bone, which are all important in the differential diagnosis. The final diagnosis was a tailgut cyst. Developmental cysts of the retrorectal area are classified according to their origin and histopathological features as epidermoid cyst, dermoid cyst, enteric or rectal duplication cyst, cystic teratoma, and tailgut cyst. The precise nature of the tailgut cysts remains controversial. Middledorpf is believed to be the first author to consider that tumors of the retrorectal area are probably derived from remnants of the postanal intestine. In 1953, Hawkins and Jackman Int J Colorectal Dis (2007) 22:1283–1285 DOI 10.1007/s00384-006-0153-2

Cystic rectal duplication in infants: A case report and review of literature

Rectal duplication is described in a 1-month-old male infant who presented with constipation for the last 5 days. A presence of a cystic mass in relation to posterior wall of rectum revealed on clinical and radiological examination provided a clue to diagnosis. The clinical presentations and the management protocol of this rare entity are discussed. Authors review their experience with this rare entity and the pertinent literature.

Tailgut cyst associated with a carcinoid tumor: case report and review of the literature.

We report the case of a 49-year-old woman who presented a tailgut cyst lined by a variety of epithelium including squamous, columnar and transitional. Fortuitously a microscopic carcinoid tumor expressing immunohistochemically neuroendocrine markers was identified in the cystic wall. Tailgut cysts are congenital abnormalities located in the presacrococcygeal area occurring usually in adult patients. Clinical diagnosis is difficult because they are often asymptomatic. Patients may present symptoms resulting from local mass effects or complications. The differential diagnoses include rectal duplication cysts, cystic sacrococcygeal teratomas, epidermal cysts, epidermoid cysts, anal duct or gland cysts. Magnetic resonance imaging has recently become the modality of choice to image the cyst. Malignant transformation is rare; 23 cases including 10 carcinoid tumors have been reported in the literature. To our knowledge, this is the eleventh case of carcinoid tumor arising in a tailgut cyst.

A rare case of adenocarcinoma arising within a duplication cyst of the rectum: curative excision with 9-year follow-up

This case report is novel in that it describes the successful excision of an adenocarcinoma arising within a rectal duplication cyst without evidence of disease recurrence at 9-years of follow-up.

Enteric and rectal duplications and duplication cysts in the adult

Alimentary tract duplication and duplication cysts are rare congenital malformations. The ileum is the most frequently affected site. However, alimentary tract duplication and duplication cysts can occur at any point along the gastrointestinal tract. Early diagnosis and prompt surgical treatment is the best way to prevent associated morbidity. This article presents the cases of three patients admitted to Gulhane Military Medical Academy with signs of acute abdomen, intra-abdominal mass and chronic abdominal pain. These patients were found to have enteric duplication, duplication cyst and/or retro-rectal cyst. The literature on alimentary tract duplications is reviewed.

Adenosquamous carcinoma arising within a retrorectal tailgut cyst: Report of a case

Retrorectal, developmental tail gut cysts, include dermoid cysts, rectal duplication cysts and retrorectal cyst-hamartomas. Retrorectal cyst-hamartomas (RCH) are derived from remnants of the tail gut, the most caudal part of the embryonic hind gut, which normally involutes by the 8(th) wk of embryonic development (3-8 mm stage). They have specific radiological and histopathological features that distinguish them from other similar formations (dermoid cysts, enteric duplication cysts and teratomas). We report a patient with adenosquamous carcinoma arising within RCH, who underwent complete resection of the cyst through anterior laparotomy, and reached complete (recurrence-free for 14 mo, so far) functional recovery. The cyst was incidentally discovered during hysterectomy 12 years ago. Diagnostic, therapeutic and histopathological aspects of this rare case are discussed. The mentioned period between diagnosis and surgical treatment suggests that RCH, given enough time, can develop malignant degeneration, and should be resected at the time of diagnosis.

Adenocarcinoma Arising in Rectal Duplication Cyst: Case Report and Review of the Literature

Duplication cyst of the gastrointestinal (GI) tract is a rare congenital anomaly, and rectal duplication cysts comprise a small fraction these cases. Most patients present for the first time in adulthood, and the origin of rectal duplication cysts is unclear. Prior series document malignant transformation in approximately 20 per cent of cases. The following case report describes a carcinoma arising in a rectal duplication cyst. Given the lack of data demonstrating adequate control for patients with adenocarcinoma arising in a rectal duplication cyst and our experience with this patient, we recommend all patients undergo multidisciplinary evaluation prior to any therapy.

Rectal Duplication Cyst Presenting as Perianal Sepsis: Report of Two Cases and Review of the Literature

Recurrent perianal sepsis is a difficult problem to manage in colorectal surgical practice. One cause is rectal duplication cyst, a rare congenital lesion that is easily overlooked. Many cases have associated congenital defects, especially musculoskeletal anomalies, and may provide a clue to the underlying condition. Early diagnosis is important because these cysts do not resolve spontaneously and may undergo malignant change. We present two cases of middle-aged females who presented with perianal sepsis secondary to rectal duplication cyst. The first case had numerous surgical procedures for a perianal fistula during a ten-year period. She had associated sacral anomalies consistent with Currarino syndrome. The second case presented with a perineal mass after a bout of perianal inflammation. Both cases had the entire cyst surgically excised. There were no complications postoperatively and no recurrence at follow-up. Histopathology revealed no malignancy in the cyst. Rectal duplication cyst is a rare cause of recurrent perianal sepsis that should be considered in difficult cases, especially in those with associated musculoskeletal anomalies. Complete surgical excision is the preferred treatment to prevent recurrence and the risk of malignant degeneration.

Anterior rectal duplication cyst lined by respiratory epithelium in an adult: TRUS, CT and MRI findings

Rectal duplication cyst is a very rare congenital anomaly. It is usually observed early in the life. A 21-year-old male had anterior rectal duplication cyst lined by respiratory epithelium, which is extremely rare type of the lining epithelial. We present typically radiologic images (TRUS, CT and MRI) of anterior rectal duplication cyst. The competence of TRUS in the diagnosis of this uncommon condition and differential diagnosis are discussed.

Anterior rectal duplication cyst lined by respiratory epithelium in an adult: TRUS, CT and MRI findings

Anterior rectal duplication cyst lined by respiratory epithelium in an adult: TRUS, CT and MRI findings

Acid-secreting rectal duplication cyst with associated peptic ulcer eroding through the anal sphincters

A rectal duplication cyst with heterotopic gastric mucosa that resulted in a trans-sphincteric peptic ulcer on the opposite wall of the anus of a child is described. The management and outcome and a review of the literature is presented. J Pediatr Surg 37:E37. Copyright 2002, Elsevier Science (USA). All rights reserved.

Tailgut cyst associated with a pilonidal sinus: an unusual case and a review.

Tailgut cysts are rare congenital abnormalities in the retrocaecal/presacral region. Clinical diagnosis is difficult and delayed and they can present in childhood and adult life with a variety of clinical symptoms and complications. Differential diagnoses include, rectal duplication cysts, cystic teratoma, epidermal cyst, anal gland cyst and anal gland carcinoma. Magnetic resonance imaging has recently become the modality of choice to image these cysts. Although Tailgut cysts rarely undergo malignant transformation, early surgical resection is presently considered the treatment of choice. Here we report the case of a 34 year old gentleman with a Tailgut cyst associated with a Pilonidal sinus, and review of the literature. We believe that the high incidence of complications associated with operations in the presacral region should be weighed against the generally benign course of these lesions, especially with the quality of modern imaging technology.

Retrorectal Developmental Cysts in Adults: Clinical and Radiologic-Histopathologic Review, Differential Diagnosis, and Treatment

Developmental cysts are the most common retrorectal cystic lesions in adults, occurring mostly in middle-aged women. They are classified as epidermoid cysts, dermoid cysts, enteric cysts (tailgut cysts and cystic rectal duplication), and neurenteric cysts according to their origin and histopathologic features. Although developmental cysts are often asymptomatic, patients may present with symptoms resulting from local mass effect (eg, constipation, rectal fullness, lower abdominal pain, dysuria), with a palpable retrorectal mass at digital rectal examination, or with a complication. Infection with fistulization, bleeding, and malignant degeneration are the major complications of developmental cysts. A well-defined, unilocular or multilocular, thin-walled cystic lesion is the main imaging feature. Uncommonly, a sacral bone defect and calcifications are associated with developmental cysts. The differential diagnosis includes cystic sacrococcygeal teratoma, anterior sacral meningocele, anal duct or gland cyst, necrotic rectal leiomyosarcoma, extraperitoneal adenomucinosis, cystic lymphangioma, pyogenic abscess, neurogenic cyst, and necrotic sacral chordoma. Complete surgical excision is indicated to establish the diagnosis and avoid complications.

Adenocarcinoma arising within a tailgut cyst: clinicopathological description and follow up of an unusual case.

Full clinicopathological details and clinical follow up of a case of malignant transformation within a tailgut cyst are presented. A 43 year old woman presented with signs and symptoms of...

Rectal duplication cyst with a large perineal hernia presenting as recurrent perineal abscesses

Forty-two-year-old woman had multiple incision and drainage procedures over 25 years for a recurrent “perianal abscess” that presented as a giant fluctuant perineal cystic collection. However, the cyst contents were always sterile. The mass was found to be contiguous with the rectum at the time of excision, consistent with a rectal duplication cyst. The perineal hernia defect was repaired and the patient has remained asymptomatic for 1 year since surgery.

Rectal duplication cyst with a large perineal hernia presenting as recurrent perineal abscesses

Forty-two-year-old woman had multiple incision and drainage procedures over 25 years for a recurrent “perianal abscess” that presented as a giant fluctuant perineal cystic collection. However, the cyst contents were always sterile. The mass was found to be contiguous with the rectum at the time of excision, consistent with a rectal duplication cyst. The perineal hernia defect was repaired and the patient has remained asymptomatic for 1 year since surgery.

Cystic rectal duplication: a rare cause of neonatal intestinal obstruction

Cystic rectal duplication: a rare cause of neonatal intestinal obstruction

Fetus in Fetu and Cystic Rectal Duplication in a Newborn

A case of sacrococcygeal teratoma is presented with characteristics of fetus in fetu in association with rectal duplication and bilateral cryptorchidism.