Tailgut Cyst Research Articles

Double tailgut cysts (presacral and precoccygeal hamartomas) with CA 19-9 elevation

Tailgut cyst, also called retrorectal hamartoma, is a rare congenital lesion and is usually located anterior to the sacrum and posterior to the rectum. We report a case of double tailgut cyst (presacral and precoccygeal hamartoma). A 62-year- old female visited the hospital complaining of anal pain and pressure in the perianal area for one month. Digital rectal examination revealed a round mass with hard consistency in the lateral and posterior part of rectum 5 cm from the anal verge. Pelvic magnetic resonance imaging showed two cystic and solid presacral masses (lateral and posterior part of rectum) compressing the rectum. The patient underwent surgical resection for pathologic diagnosis. At operation, two masses were located in the left presacral space without invasion to adjacent organs and soft tissue. Pathologic examination revealed double tailgut cysts without malignant transformation. A differential diagnosis of perirectal cystic hamartoma includes epidermal cysts, cystic teratomas, dermoid cysts, anal gland cysts, sarcoma and rectal duplications. Regional inflammatory process frequently complicates this lesion and perirectal fistula can develop. Tailgut cyst also has a malignancy potential, with development of adenocarcinomas. To establish a definite diagnosis and prevent complication, complete surgical resection is recommended.

直腸癌に併存したtailgut cystの1例

直腸癌に併存したtailgut cystの症例を経験したので報告する．症例は55歳女性．直腸癌の術前CTにて直腸背側に不整形腫瘤を認め，直腸固有筋膜外への転移性病変などの可能性を考慮した．しかし，MRIでは境界明瞭な多房性嚢胞性病変として認められたため，tailgut cystの診断にて，経仙骨的に摘出術を施行した．Tailgut cystは直腸背側に発生する嚢胞性腫瘤であり，直腸癌との併存は稀なので，若干の文献的考察を加えて報告する．

A Tailgut Cyst—Cystic Mass Diagnosed by Prenatal Ultrasonography

Tailgut cysts are congenital lesions found in the presacral space. These have been mainly identified in adults and are rare in children, especially neonates. Here, we present the case of a neonate with a presacral cystic mass detected by prenatal ultrasonography that was diagnosed as a tailgut cyst after postnatal surgical removal. When a presacral cyst is encountered, tailgut cyst should be considered in the differential diagnosis.

Case report: Retroperitoneal epidermoid cyst

Cystic lesions of retroperitoneum can be classified as either neoplastic or nonneoplastic. Neoplastic lesions include cystic lymphangiomas, mucinous cystadenomas, cystic teratomas, cystic mesotheliomas, mullerian cysts, epidermoid cysts, tailgut cysts, bronchogenic cysts, cystic changes in solid neoplasms, pseudomyxoma retroperitonei, and perianal mucinous carcinomas. Nonneoplastic lesions include pancreatic pseudocysts, lymphoceles, urinomas, and hematomas. Retroperitoneal epidermoid cysts are very rare and may be incidentally discovered during the investigation of irrelevant diseases or routine abdominal USG. In addition, they may be clinically asymptomatic or show nonspesific symptoms. Differantial diagnosis of epidermal cysts is required to be performed from other intraabdominal and retroperitoneal cysts. A 25-yearold female patient applying to the clinic was determined to have a retroperitoneal located epidermoid cyst via USG and MRI, and the case was considered to be a rare one.

Tailgut cyst: A case report in a 9-month-old infant

INTRODUCTIONTailgut cysts or retrorectal cystic hamartomas are rare developmental anomalies that are believed to arise from the embryonic hindgut. PRESENTATION OF CASE9 months old male infant was presented with swelling in the right gluteal region. MRI lumbo-sacral spine showed well defined round to oval lesion which is brightly hypertense on T2W1 and hypotense on T1W1 posterior to sacrum and coccyx with no evidence of connection to the thecal sac indicating cyst. Complete excision of the cyst was done. Histopathology report shows cyst wall partially lined with stratified squamous epithelium and cyst wall shows spaces lined by cuboidal epithelium and nerve bundles with no evidence of malignancy suggestive of tailgut cyst. DISCUSSIONTailgut cysts are rare congenital anomalies. Most commonly located in the retrorectal space. They are thought to be derived from the remnants of the embryonic hindgut. Age ranges from 4 to 73 years but an average presentation is at 35 years. Female to male ratio is 3:1. MRI is a good diagnostic tool for diagnosis of tailgut cyst. Complete surgical excision is the treatment of choice as this provides a definite diagnosis and prevents possible complications such as infection, fistula formation and malignant degeneration. CONCLUSIONThe aim of presenting this case is its rarity. Complete surgical excision is the treatment of choice. Preoperative imaging with MRI is essential to plan the most appropriate surgical approach.

尾骨直下の後直腸部に tailgut cyst を有していた coccygeal pad の1例

尾骨直下の後直腸部に tailgut cyst を有していた coccygeal pad の1例

Adenocarcinoma associated with tail gut cyst.

Primary adenocarcinomas of the presacral (retrorectal) space are rare. The diagnosis is usually delayed because of non-specific symptoms, and is made after a biopsy or surgery. These carcinomas arise from cystic lesions developing from remnants of the embryological postanal gut containing mucous-secreting epithelium, known as tail gut cysts. The potential for infection, perianal fistulas and most importantly, malignant change warrants an early complete surgical resection. From an oncologist's perspective, the management of these carcinomas has varied, and has included adjuvant chemotherapy and/or radiation therapy. We describe here a rare case of adenocarcinoma associated with a tail gut cyst that was discovered incidentally and resected by a posterior approach (Kraske procedure). The patient has had clinical and periodic radiologic surveillance without any evidence of cancer recurrence for over a year and a half.

Retrorectal tumours: optimization of surgical approach and outcome

The aim was to identify the radiological features of retrorectal tumours that influence management and to highlight technical points that facilitate safe surgical excision. A consecutive series of patients was identified from a prospective database. All cases were discussed within a multidisciplinary team. Medical records, radiology and pathology reports were also checked retrospectively. Fifty-six patients [37 women; median age 51 (20-88) years] underwent excision of retrorectal tumours between 2002 and 2010 under the care of one surgeon. Seventeen (37.5%) had a malignant tumour. The commonest symptom was pain or discomfort. Features identified after MRI that suggested malignancy included heterogenous signal intensity (15/17 malignant lesions vs 5/39 benign lesions), an irregular infiltrative margin (14/17 malignant lesions vs 4/39 benign lesions) and enhancement (14/17 malignant lesions vs 2/39 benign lesions) (all P < 0.05). An abdominal approach was used in 27 (48%) patients, a perineal/trans-sacral approach in 20 (36%) and a composite abdomino-sacral approach in nine (16%). The perineal approach was used if the tumours were below the middle of S3 without sacral, pelvic side-wall or visceral involvement. The three most common types of tumour were schwannoma (n = 11), tail gut cyst (n = 13) and chordoma (n = 9). Over a median follow-up period of 46 (6-90) months there were two local recurrences among the malignant tumours (both resected) and two deaths (both sarcomas). MR imaging, avoidance of routine preoperative biopsy and careful clinical evaluation result in a good outcome after surgical excision of retrorectal tumours.

Surgical excision of developmental retrorectal cysts: results with long-term follow-up from a single institution

Developmental cysts are very rare lesions occurring in the retrorectal space, and include epidermoid, dermoid, tailgut cysts and teratomas. There is little information on their natural history and biologic behavior, although a recent paper reported a greater incidence of malignant transformation than previously thought. The diagnosis requires high-resolution imaging, and complete surgical excision is the treatment of choice. In this paper we analyzed short- and long-term results of surgical excision of six retrorectal developmental cysts observed at our institution over a period of 11 years. All patients were women, three were referred with an infected perineal fistula/pelvic abscess after having undergone drainage surgery elsewhere. In these three patients, excision was attempted through a trans-perineal approach, which was technically demanding and ultimately incomplete because of the intense surrounding inflammation. Multiple re-interventions were required for tumor recurrence, and two of them still present an occasional perineal discharge. In the other three patients, a trans-perineal or trans-anal route was employed according to tumor location, without any recurrence at a median follow-up of 118.5 months. Final pathologic diagnosis included five tailgut cysts and one teratoma. This paper shows that the treatment of developmental cysts may be very challenging, especially when they are associated with a concomitant fistula/abscess and are not correctly diagnosed at presentation. In our experience, healing was finally achieved in four patients out of six. All the lesions were benign, and no malignant transformation was observed during follow-up, even in tumors partially resected.

Tailgut Cyst Prolapsing through the Anus

The tailgut cyst is a rare congenital malformation. It is a remnant of the postanal part of the hindgut, which normally regresses totally during the embryonic period. Most cases are asymptomatic and are diagnosed by incident as a presacral mass, other cases may present with different and unspecific symptoms.[1] [2] [3] [4] [5] This case presenting as a prolapse through the anus has, to our knowledge, not been reported previously.

Unusual cause of CA 19.9 elevation diagnosed by endoscopic ultrasound-guided fine needle aspiration: a retrorectal tailgut cyst

Unusual cause of CA 19.9 elevation diagnosed by endoscopic ultrasound-guided fine needle aspiration: a retrorectal tailgut cyst

Uncommon Primary Pelvic Retroperitoneal Masses in Adults: A Pattern-based Imaging Approach

There is a broad spectrum of primary pelvic retroperitoneal masses in adults that demonstrate characteristic epidemiologic and histopathologic features and natural histories. These masses may be classified into five distinct subgroups using a pattern-based approach that takes anatomic distribution and certain imaging characteristics into account, allowing greater accuracy in their detection and characterization and helping to optimize patient management. The five groups are cystic (serous and mucinous epithelial neoplasms, pelvic lymphangioma, tailgut cyst, ancient schwannoma), vascular or hypervascular (solitary fibrous tumor, paraganglioma, pelvic arteriovenous malformation, Klippel-Trénaunay-Weber syndrome, extraintestinal GIST [gastrointestinal stromal tumor]), fat-containing (lipoma, liposarcoma, myelolipoma, presacral teratoma), calcified (calcified lymphocele, calcified rejected transplant kidney, rare sarcomas), and myxoid (schwannoma, plexiform neurofibroma, myxoma).Cross-sectional imaging modalities help differentiate the more common gynecologic neoplasms from more unusual masses. In particular, the tissue-specific multiplanar capability of high-resolution magnetic resonance imaging permits better tumor localization and internal characterization, thereby serving as a road map for surgery.

Acute Urinary Retention and Obstipation: A Rare Cause…

Tailgut cysts are rare congenital anomalies, believed to be remnants of the primitive embryonic hindgut. In addition to causing genitourinary and bowel obstructive symptoms, they have been reported to harbour occult adenocarcinoma. Varying positions of a tailgut cyst with respect to the rectum have also been reported in literature. We present a rare presentation of this disease vis a vis obstipation and acute urinary retention in a 70 year old man.

A Rare Cause of Low Back Pain: Report of a Tailgut Cyst

Tailgut cysts, also known as retrorectal cystic hamartomas, are rare developmental abnormalities that typically occur in the retrorectal space. They are believed to arise from remnants of the embryonic hindgut (Hjermstad and Helwig, 1988). They can present as incidental findings during routine examination but over half of patients are thought to present with symptoms. MRI has become the modality of choice to image these frequently misdiagnosed cysts. Biopsy is not recommended. Complete intact surgical excision is advised to avoid the potential complications of these cysts which include infection, fistula formation, and the possibility of malignant transformation (Hjermstad and Helwig (1988), Mathis et al. (2010)). We describe the case of a 46-year-old female who presented with a 6-month history of low back pain. CT and MRI imaging demonstrated a complex retrorectal lesion with supralevator and infralevator components. This was removed using a combined transperineal and transabdominal approach. Histology confirmed a tailgut cyst.

妊娠中に発見されたtailgut cystの1例

妊娠中に発見されたtailgut cystの1例

Tailgut Cysts: What is the Best Surgical Approach?

Tailgut Cysts: What is the Best Surgical Approach?

L’hamartome kystique rétrorectal (HKRR) : à propos d’un cas réséqué par abord vaginal et revue de la littérature

Tailgut cyst is a rare congenital presacral lesion. We report a case of a 24-year-old woman presenting a recurrent retrorectal mass with pain. Surgical resection by vaginal way found retrorectal cystic hamartoma. Differential diagnosis include cystic teratoma, epidermal cyst and rectal duplication cysts. The most important complications are recurrence, infection, perineal fistulas and the possibility of malignant transformation. So the complete surgical excision of these lesion is necessary.

Isolated intradural lumbosacral tailgut cyst with carcinoid features

Tailgut cysts are developmental cysts that arise from remnants of the embryonic postanal gut and are typically located within the presacral, retrorectal space. Isolated cases of aberrant locations, including prerectal, perirenal, perianal, retrovesical, and subcutaneous locations, have been reported. Malignant transformations with the presence of adenocarcinomas or carcinoids have been recognized within these entities. It is well recognized that anterior sacrococcygeal abnormalities are present and are frequently caused by the slow-growing nature of the tailgut cysts and related mass effect; however, the authors are aware of no reports in the literature of isolated tailgut cysts within the thecal sac in direct contact with neural elements, without extension into the peritoneal cavity. In this case, a 28-year-old woman presented with progressive back pain, frequent urinary tract infections, and bowel dysfunction. She was found to have a purely intradural tailgut cyst with malignant transformation consistent with carcinoid. No peritoneal extension of her disease was found. The authors hypothesize that this is a rare developmental aberration that has not been commonly recognized and potentially has implications for embryological development.

Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults

PurposeA retrorectal developmental cyst (tailgut cyst, epidermoid cyst, dermoid cyst, teratoma, and duplication) is very rare disease, and the symptoms are not characteristic so that sometimes this disease is still misdiagnosed as a supralevator abscess or a complex anal fistula. We would like to present a clinical approach to this disease.MethodsWe retrospectively examined the charts of 15 patients who were treated for retrorectal cysts from January 2001 to November 2009.ResultsAll 15 patients were female. The average age was 41 years (range, 21 to 60 years). Fourteen patients (93.3%) were symptomatic, and the most common symptom was anal pain or discomfort. Nine patients (60%) had more than one previous operation (range, 1 to 9 times) for a supralevator abscess, an anal fistula, etc. In 12 patients (80%), the diagnosis could be made by using the medical history and physical examination. Thirteen cysts (80%) were excised completely through the posterior approach. The average diameter of the cysts was 4.8 cm (range, 2 to 10 cm). Pathologic diagnoses were 8 tailgut cysts (53.3%), 5 epidermoid cysts (33.3%) and 2 dermoid cysts (13.3%). The average follow-up period was 18.3 months (range, 1 to 64 months).ConclusionIn our experience, high suspicion and physical examination are the most important diagnostic methods. If a female patient has a history of multiple perianal operations, a retrorectal bulging soft mass, a posterior anal dimple, and no conventional creamy foul odorous pus in drainage, the possibility of a retrorectal developmental cyst must be considered.

Primär metastasierter hochdifferenzierter neuroendokriner Tumor in einer Tailgut-Zyste

Tailgut cysts are unusual benign cystic retrorectal malformations arising from persistent remnants of the postanal gut. Malignant transformation within this dysontogenetic lesion is very uncommon. We report the rare occurrence of a neuroendocrine tumor arising in a tailgut cyst with primary liver and lymph node metastases in a 55-year-old woman. The neuroendocrine differentiation of the tumor determines the therapeutic approach and prognosis.