Unusual prerectal location of a tailgut cyst: A case report

Department of Pathology, College of Medicine, Hanyang University, Seongdong-Gu, Seoul 133-792, Korea.
World Journal of Gastroenterology (Impact Factor: 2.37). 09/2006; 12(31):5081-3.
Source: PubMed


Tailgut cyst is a rare congenital cystic lesion arising from the remnants of the embryonic postanal gut. It occurs exclusively within the retrorectal space and rarely in the perirenal area or in the subcutaneous tissue. A prerectal and retrovesical location of tailgut cyst is extremely rare. To the best of our knowledge, only three cases have been reported in the English literature. We experienced an unusual case of tailgut cyst developed in the prerectal and retrovesical space in a 14-year-old boy. Abdominal computed tomography demonstrated a prerectal cyst which was located at the anterolateral portion to the rectum. The cyst contained yellowish inspissated mucoid material. Microscopically, the cyst was lined by squamous, columnar, cuboidal and transitional epithelia and the wall was fibrotic with dispersed smooth muscle cells. Although tailgut cyst arising in prerectal area is extremely rare, its possibility should be considered in differential diagnosis of a prerectal and retrovesical cystic mass.

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    • "Tailgut cysts, also known as retrorectal cystic hamartomas, are rare congenital lesions that almost invariably occur in the retrorectal space but have been described in prerectal [1] and perirenal [2] locations. The retrorectal space is a potential space bound anteriorly by the mesorectum and posteriorly by the sacrum. "
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    ABSTRACT: 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.
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    ABSTRACT: An illustration of the diagnosis and management of tailgut cysts. Two cases of tailgut cyst and a review of the literature. A female patient presented with acute urinary retention with a retrorectal mass felt during rectal examination and confirmed on ultrasound and magnetic resonance imaging underwent surgical resection and histology confirmed a chronically inflamed mucoid fluid-filled cyst partly lined by non-keratinised squamous epithelium. A male patient with ureteric obstruction and a prerectal cyst found on ultrasound scan underwent computed tomography with biopsies, but without reaching a conclusive diagnosis. Surgical resection was carried out and histology showed a chronically inflamed mucoid fluid-filled cyst partly lined with columnar epithelium. Tailgut cysts are a rare developmental abnormality arising from remnants of the embryological postanal gut. Usually presenting incidentally or with pressure symptoms in middle-aged females, tailgut cysts are often initially mistaken for other clinical entities. Magnetic resonance imaging helps to differentiate tailgut cysts from other retrorectal lesions and developmental cysts. Histologically, the cyst wall demonstrates a wide variety of epithelial types and has a malignant potential. Malignancy is difficult to rule out with imaging or biopsy. Magnetic resonance imaging is the favoured imaging modality and surgical resection is recommended to relieve pressure symptoms, provide a definitive diagnosis and rule out malignancy.
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