Tailgut Cyst Research Articles

Minimally invasive approach for retrorectal tumors above and below S3: a multicentric tertiary center retrospective study (MiaRT study)

BackgroundRetrorectal tumors are uncommon lesions developed in the retrorectal space. Data on their minimally invasive resection are scarce and the optimal surgical approach for tumors below S3 remains debated.MethodsWe performed a retrospective review of consecutive patients who underwent minimally invasive resection of retrorectal tumors between 2005 and 2022 at two tertiary university hospital centers, by comparing the results obtained for lesions located above or below S3.ResultsOf over 41 patients identified with retrorectal tumors, surgical approach was minimally invasive for 23 patients, with laparoscopy alone in 19, with transanal excision in 2, and with combined approach in 2. Retrorectal tumor was above S3 in 11 patients (> S3 group) and below S3 in 12 patients (< S3 group). Patient characteristics and median tumor size were not significantly different between the two groups (60 vs 67 mm; p = 0.975). Overall median operative time was 131.5 min and conversion rate was 13% without significant difference between the two groups (126 vs 197 min and 18% vs 8%, respectively; p > 0.05). Final pathology was tailgut cyst (48%), schwannoma (22%), neural origin tumor (17%), gastrointestinal stromal tumor (4%), and other (19%). The 90-day complication rates were 27% and 58% in the > S3 and < S3 groups, respectively, without severe morbidity or mortality. After a median follow-up of 3.3 years, no recurrence was observed in both groups. Three patients presented chronic pain, three anal dysfunction, and three urinary dysfunction. All were successfully managed without reintervention.ConclusionsMinimally invasive surgery for retrorectal tumors can be performed safely and effectively with low morbidity and no mortality. Laparoscopic and transanal techniques alone or in combination may be recommended as the treatment of choice of benign retrorectal tumors, even for lesions below S3, in centers experienced with minimally invasive surgery.

Presacral Neuroendocrine Neoplasms: A Multi-site Review of Surgical Outcomes.

Presacral neuroendocrine neoplasms (PNENs) are rare tumors, with limited data on management and outcomes. A retrospective review of institutional medical records was conducted to identify all patients with PNENs between 2008 and 2022. Data collection included demographics, symptoms, imaging, surgical approaches, pathology, complications, and long-term outcomes. Twelve patients were identified; two-thirds were female, averaging 44.8years of age, and, for the most part, presenting with back pain, constipation, and abdominal discomfort. Preoperative imaging included computed tomography scans and magnetic resonance images, with somatostatin receptor imaging and biopsies being common. Half of the patients had metastatic disease on presentation. Surgical approach varied, with anterior, posterior, and combined techniques used, often involving muscle transection and coccygectomy. Short-term complications affected one-quarter of patients. Pathologically, PNENs were mainly well-differentiated grade 2 tumors with positive synaptophysin and chromogranin A. Associated anomalies were common, with tail-gut cysts prevalent. Mean tumor diameter was 6.3cm. Four patients received long-term adjuvant therapy. Disease progression necessitated additional interventions, including surgery and various chemotherapy regimens. Skeletal, liver, thyroid, lung, and pancreatic metastases occurred during follow-up, with no mortality reported. Kaplan-Meier analysis showed a 5-year local recurrence rate of 23.8%, disease progression rate of 14.3%, and de novo metastases rate of 30%. The study underscores the complex management of PNENs and emphasizes the need for multicenter research to better understand and manage these tumors. It provides valuable insights into surgical outcomes, recurrence rates, and overall survival, guiding future treatment strategies for PNEN patients.

Analysis of the clinicopathological features of tailgut cyst with emphasis on the development of neoplastic lesions.

Tailgut cyst is a rare congenital cyst occurring in the retrorectal space and development of neoplastic lesions in tailgut cyst has been reported. Due to the rarity of the tumor, the histogenesis of neoplastic lesions in tailgut cyst has remained elusive. In the present study, the clinicopathological features of tailgut cyst were analyzed with a particular focus on the development of neoplastic lesions. The clinicopathological features of four patients with tailgut cyst (one female and three males) were retrospectively reviewed. No symptoms were present in two patients. Perineal discomfort, and constipation and urinary retention, were described in the other two patients, respectively. Magnetic resonance imaging showed that the cystic lesions were hypointense on T1- and hyperintense on T2-weigted images in all patients. Histopathological analysis revealed that all lesions were multilocular, and cystic walls were covered by squamous and ciliated epithelia without nuclear atypia. The development of neoplastic lesions was noted in two patients. Dysplastic change composed of piling-up proliferation of glandular cells with mild to moderate nuclear atypia was present in one patient, and invasive adenocarcinoma with a dysplasia component was observed in another patient. Dysplasia of the glandular cells, as seen in two patients in the present series, may be a precursor lesion of invasive adenocarcinoma; therefore, adenocarcinoma arsing in tailgut cyst may show a dysplasia-carcinoma sequence. While the reported incidence of neoplastic lesions in tailgut cysts is ~9% or less, their frequency remains to be accurately determined. Therefore, complete surgical resection is important for the management of patients with tailgut cyst. Additional clinicopathological and molecular studies with large cohorts may be required to clarify the histogenesis of neoplastic lesion in tailgut cyst.

Presacral Tailgut Cyst.

A tailgut cyst is a rare benign polycystic congenital lesion in presacral or retrorectal space, when there is failure of involution of tailgut. Clinical presentation may be with or without symptoms of different types related to obstruction, infection, or rarely malignancy. Symptoms may be misleading and atypical, so understanding of characteristics of tailgut cysts is important for precise and early diagnosis to be made for proper treatment and to avoid complications and malignant transformation. Magnetic resonance imaging pelvis was used as diagnostic imaging investigation, but the final confirmation was only done by histopathology. Definitive treatment is surgery, though various surgical approaches are described, surgery is tailored which will suit the individual patient's anatomy and suspected diagnosis of mass. This case review used PubMed and Web of Science databases to search for the studies. We found around 176 articles and selected 77 articles in our survey, with 8 reviews, 31 case reports, and 31 case reports and reviews.

Perineal hernia repair following tailgut cyst excision: A case report and literature review of optimal management strategies

Perineal hernias, categorised as primary or secondary, pose a clinical challenge necessitating surgical intervention. Herein we present the surgical management of a postoperative perineal hernia of the retrorectal space. A 42-year-old female patient presented to the clinic with symptoms such as perineal discomfort, bulging, and constipation after previous surgical tailgut cyst excision. Diagnosis involved MRI, confirming rectal herniation into the retrorectal space. The surgical approach featured a perineal intervention using a unilateral inferior gluteal flap to reinforce the posterior rectal space, avoiding mesh complications. The patient experienced a successful recovery, highlighting the importance of tailored interventions based on symptoms and complications. Secondary perineal hernias, often postoperative, present diverse challenges influenced by multiple factors such as pelvic surgeries. Surgical repair options include perineal and abdominal approaches, mesh usage, and flap methods, each with variable outcomes. This case study contributes to the evolving understanding of perineal hernias, emphasising the need for multidisciplinary approaches and ongoing research to enhance management strategies in this complex clinical scenario.

Posterior paracoccygeal approach for tailgut cyst (with video)

Posterior paracoccygeal approach for tailgut cyst (with video)

Tailgut Duplication Cyst: A Rare Cause of Refractory Low Back Pain in a Teenage Girl - A Case Report

Tailgut cyst, or retrorectal cystic hamartoma, is a rare congenital malformation originating from retrorectal or presacral space. It stands as an embryonic vestige of the hindgut’s postnatal component. Owing to its rarity, undiagnosed asymptomatic cases and diverse array of clinical presentations that potentially mimic other diseases, correct diagnosis is often delayed. It can present at any age but is most prevalent in middle-aged females, often remaining asymptomatic and eluding detection during digital rectal examinations. Postoperative histopathological examination is the definitive diagnostic method. This case report highlights an unusual presentation of a tailgut cyst as an underlying etiology for lower back pain in a 17-year-old female patient, emphasizing the importance of considering it as a potential differential diagnosis for intractable lower back pain, especially in young females. Timely recognition of this condition is pivotal for precise management and better patient outcomes.

Tail gut cyst adenocarcinoma: A rare entity diagnosed on cytology

Tailgut cyst is a rare benign cystic lesion believed to originate from small portions of the embryonic tailgut, which normally disappear in early foetal development. It is often misdiagnosed due to the general unawareness with this entity and also because of its clinical presentation similar to other common diseases such as perianal fistulas or abscesses.We take this opportunity to report a case of tailgut cyst in a 33-year-old Indian male. The patient had presented with painful swelling in sacral region, which had been gradually increasing in size. The case was diagnosed by fine needle aspiration cytology (FNAC) as adenocarcinoma arising in tailgut cyst and later confirmed by histopathology.Tailgut cysts are congenital cystic hamartomatous lesions, which occur very rarely. They are generally benign, but malignant change or transformation in it has also been reported, which is even rarer in occurrence. FNAC is an effective diagnostic tool, which if applied appropriately can be used for the early detection of these lesions and also malignant transformation of tailgut cyst.

Retrorectal tailgut cyst: a case report

Background: Tailgut cysts are rare congenital malformation lesions, also known as retrorectal cystic hamartoma is defined as a remnant part of postnatal hindgut. Because of their rare incidence and nonspecific presentation, tailgut cysts are misdiagnosed. The symptoms depend on the size and the location of the tumor. Surgical intervention is always required because of the complications of these tumors. Case Presentation: We report a 40-year-old female patient with an uneventful past surgical and medical history. Presented to the outpatient clinic with vague abdominal pain and constipation for 1 and a half years. The rectal digital examination, computed tomography abdomen, and pelvis with contrast and magnetic resonance imaging pelvis indicated the presence of the tailgut cyst, intraoperative we found two retrorectal cysts, and complete surgical resection using a posterior approach was performed. The histopathology examination showed a 5 * 5 cm cyst filled with putty-like material, defined as an epidermal inclusion cyst. The patient recovered well and was discharged 6 days after surgery. Out patient clinic follow up was uneventful and the patient was discharged from the surgical side. Conclusion: Tailgut cysts originate from the postanal gut of the embryo. These cysts are typically asymptomatic, surgical removal via a posterior or anterior approach is recommended once these lesions are detected due to the possibility of malignant development, infection, retrorectal abscesses formation, and rarely anal fistulas. A variety of surgical techniques can be employed, and the course of treatment can be customized to fit the anatomy and suspected lesion diagnosis of each patient.

Robotic approach to remove four tailgut cyst cases in Brazil: a case series

Robotic approach to remove four tailgut cyst cases in Brazil: a case series

RETRORECTAL TUMORS –A CASE SERIES

Objective: Retro-rectal tumors are uncommon lesions that present with non-specic signs and symptoms, making the diagnosis of these tumors very difcult. We present signicant number of cases in view of scarce information available on this matter. 5 patients were treated at Methods: SVS Medical College and hospital 2018 to 2022. The case notes of patients who underwent surgery for a retro-rectal tumor were reviewed retrospectively. Surgical histories, operations, histological tumor type, surgical time, weight of the specimen, blood loss, length of stay were analyzed. 4 patients underwent laparotomy, 1 patient had combined perineal approach Results: and laparotomy. The most common types of the tumor were broma (2 cases), dermoid tumor (2 cases), tail gut cyst (1case). 80% of the patients had undergone at least one operation prior to denitive treatment. 5 female patients were initially admitted under surgery. Hospital stay varied from 9 days to 14 days (mean 11 days). A report of a representative case is presented. Retro-rectal lesions in female pat Conclusions: ients can mimic gynecological pathology. Patients with this rare pathology are to be treated in a major tertiary hospital by surgeons, who are able to operate safely in the retro-rectal space.

TAILGUT CYST: A RARE CASE REPORT

Objective: Tailgut cysts are rare retro rectal masses often presenting with non-specic symptoms which are challenging to diagnose and manage. Methods: A 40 year old female presented with abdominal distention and urinary retention on further evaluation diagnosis of tail gut cyst has been made with retro rectal tumors as differential diagnosis and was operated through trans-abdominal cyst excision. On histo-pathological examination diagnosis was conrmed. Retro-rectal lesions in female patients can mim Conclusions: ic gynecological pathology. Patients with this rare pathology are to be treated in a major tertiary hospital by surgeons, who are able to operate safely in the retro-rectal space.

Malignant transformation of perianal tailgut cyst: A case report

Tailgut cyst is a congenital enterogenous cyst that rarely undergoes malignant transformation. Its clinical manifestations mainly correlate to the mass effect caused by the development of cysts and the infections that originate from these. Furthermore, the complete resection of this cyst is curative. We report our diagnostic and treatment experience with one case of malignant transformation of a perianal tailgut cyst, which was initially misdiagnosed as perianal abscess. A 72-year-old woman visited our institution with complaints of a refractory nonhealing lesion on the right hip, which repeatedly broke and suppurated for more than 70 years, and aggravated in 4 mo. The patient was given a diagnosis of refractory perianal abscess with repeated incision and drainage procedures. Computed tomography of the pelvic cavity revealed a giant perianal cyst. Subsequent biopsy revealed a tumor with moderate-to-severe glandular epithelial dysplasia, and suggested that this was derived from the developmental cysts in the posterior rectal space. After further clarifying the nature and extent of the tumor by magnetic resonance imaging, total cystic resection was performed. Postoperative histopathological examination confirmed the malignancy, dictating the investigators to add postoperative chemotherapy to the treatment regimen. The malignant transformation of perianal tailgut cysts is very uncommon, and this should be differentiated from perianal abscess. Complete surgical removal is curative, and postoperative pathology may determine the necessity of additional postoperative chemotherapy or radiotherapy, which may be beneficial for preventing local recurrence and metastasis.

Liver metastases of a neuroendocrine tumor arising from a tailgut cyst treated with interventional locoregional therapies: a case report and review of the literature on recurrent cases.

A tailgut cyst is a rare, developmental cyst occurring in the presacral space. Although primarily benign, malignant transformation is a possible complication. Herein, we report a case of liver metastases after resection of a neuroendocrine tumor (NET) arising from a tailgut cyst. A 53-year-old woman underwent surgery for a presacral cystic lesion with nodules in the cyst wall. The tumor was diagnosed as a Grade 2 NET arising from a tailgut cyst. Thirty-eight months after surgery, multiple liver metastases were identified. The liver metastases were controlled with transcatheter arterial embolization and ablation therapy. The patient has survived for 51months after the recurrence. Several NETs derived from tailgut cysts have been previously reported. According to our literature review, the proportion of Grade 2 tumors in NETs derived from tailgut cysts was 38.5%, and four of the 5 cases of Grade 2 NETs (80%) relapsed, while all eight cases of Grade 1 NETs did not relapse. Grade 2 NET may be a high-risk group for recurrence in NETs arising from tailgut cysts. The percentage of Grade 2 NETs in tailgut cysts was higher than that of rectal NETs, but lower than that of midgut NETs. To the best of our knowledge, this is the first case of liver metastases of a neuroendocrine tumor arising from a tailgut cyst that was treated with interventional locoregional therapies, and the first report to describe about the degree of malignancy of neuroendocrine tumors originating from tailgut cysts in terms of the percentage of Grade 2 NETs.

TAIL GUT CYST- A RARE FINDING- CASE REPORT AND REVIEW OF LITERATURE

Introduction: Tailgut cysts are rare congenital entity that arises from the embryological hindgut and usually located in presacral space. Here we report a case of tail gut cyst which is an infrequent condition. Case report: Here, we report a nineteen year old male with lower abdominal pain. The relevant investigations were performed. The CT abdomen revealed a well-dened cystic lesion in the pelvis in lower presacral region and posterior to rectum with small calcied foci suggestive of tail gut cyst with scalloping of sacrum. MRI pelvis suggested large well dened unilocular cystic lesion in the retro-rectal and pre-sacral region extending from S2 to mid coccygeal level showing thin imperceptible walls few tiny projections and small rounded non enhancing nodule along its posterior wall with thin focal calcication seen in its wall with no evidence of malignancy and no signs of osseous destruction. The patient was explored and intraoperatively ndings revealed a cyst of size 8 cm * 5 cm behind the rectum and in front of sacrum which was densely adhered to the posterior wall of rectum but free from sacrum. The mass was resected as a whole and sent for histopathological exam which was suggestive of tailgut cyst. Tailgut cysts is infrequent condition which manifests as chronic lower abdominal pai Conclusion: n. It is crucial that such entity be diagnosed and surgically excised early in its presentation. It is important to rule out malignancy in the post operative biopsy

Cystic lesions of the retrorectal space.

Cysts of the retrorectal space comprise a heterogeneous group of rare lesions. Most develop from embryological remnants and include tailgut cysts, dermoid cysts, rectal duplication cysts, anal canal duplication cysts, sacrococcygeal teratomas and anterior meningocoele. Tailgut cyst is the most common cyst of developmental origin, usually presenting as a multilocular cystic mass with mucoid content and lined by multiple epithelial types. Compared with tailgut cysts, rectal duplication cysts display all layers of the large bowel wall including a well-defined muscularis propria. Retrorectal cysts of non-developmental origin are far less common and represent lesions that either infrequently involve the retrorectal space or undergo extensive cystic change. This review provides an overview of the various histological types of cystic lesions of the retrorectal space, divided into cysts of developmental origin and those of non-developmental origin. A practical pathological and multidisciplinary approach to diagnosing these lesions is presented.

Tailgut Cyst – A Case Report

AbstractRetrorectal hamartoma, also called tailgut cyst, is a congenital lesion resulting from the non-regression of embryo remnants of the hindgut. We describe in this work the case report of a 68-year-old man, previously healthy, complaining of rectal bulging for 4 months, which was diagnosed by nuclear magnetic resonance imaging as a multiloculated and mucinous lesion, suggestive of tailgut cyst. In view of the finding, the lesion was surgically resected, due to the potential for future complications, and, through the anatomopathological analysis, there were no findings of malignancy in the specimen.

The management of retrorectal tumours: tertiary centre retrospective study

AimTumours of the retrorectal space are uncommon, pathologically heterogeneous, and difficult to diagnose, with ongoing controversy over their surgical management. The aim of this study was to evaluate the surgical management of a consecutive series of patients who had undergone excision of primary retrorectal tumours (PRRTs) at a tertiary referral centre.MethodPatients were identified from a prospectively maintained database between 1 March 2001 and 1 August 2021. Electronic patient records were reviewed for demographics, preoperative imaging, operative details, histology, and follow-up. A chi-squared test was used to assess the statistical significance of findings.ResultsA total of 144 patients were included in the study. Of these, 103 patients were female (71.5 per cent), 46 patients (31.9 per cent) presented incidentally, and 99 of the patients had tumours located below S3 (68.7 per cent). Overall, 76 patients underwent a transperineal approach (52.7 per cent) with the most common findings of a benign tailgut cyst occurring in 59 (40.9 per cent) of cases. Preoperative MRI predicted urovascular and pelvic sidewall involvement assessed intraoperatively with a sensitivity of 83.3 and 90 per cent and a specificity of 98.1 and 98 per cent respectively. Risk of malignancy in solid tumours was 31.4 versus 8.8 per cent in cystic tumours (relative risk 3.5, 95 per cent c.i. 1.6 to 7.6, P < 0.001). Major complications (Clavien–Dindo grade III and above) occurred in eight patients (5.6 per cent) and all-cause long-term mortality was 4.8 per cent (seven patients).DiscussionPRRTs can be safely excised with minimal complications in specialized centres by surgical teams with the relevant expertise. This study questions the conservative management of cystic tumours and given the risk of solid tumour malignancy, supports surgical management.

Robotic abdominal resection of tailgut cysts - A technical note with step-by-step description.

AimHere, we describe a step‐by‐step standardized technique for tailgut cyst resection using a single‐docking robotic approach.MethodEach step of the technique is illustrated using a composite collection of four operative patient videos to demonstrate the advantages and feasibility of this technique. The robot platform utilised is Da Vinci Xi.ResultsFive female patients have undergone this operation in our unit. The size of tumours ranged from 12 to 45 mm. Median operating time was 100 min (range 90–150). Mean blood loss in all the patients was less than 50 ml. There were no major intraoperative complications. One patient had a postoperative presacral collection which required radiological drainage. Length of stay in all patients was one day.ConclusionsThis technique using a single‐docking robotic approach appears safe and feasible. The robotic approach results in improved dexterity and more accurate dissection, better retraction and excellent vision which improves the ease of operating in the pelvis. Therefore, this approach can be replicated for use in a wide variety of patients with tailgut cysts.

Preterm Infant of Diabetic Mother with a Retrorectal Mass: A Troubling Tail Tale.

Preterm Infant of Diabetic Mother with a Retrorectal Mass: A Troubling Tail Tale.