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      Perianal Tailgut Cyst: An Unusual Presentation

      case-report
      Author(s): 1 , 1 , , 1 , 1 , 1
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: perianal cyst, pedunculated mass, perianal lesion, tailgut cyst, surgical case reports

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          Abstract

          A tailgut cyst (TGC) is a rare congenital lesion that occurs due to failure of involution of the distal hindgut, leading to the development of a mucus-secreting cyst. The clinical presentation is nonspecific, and often the diagnosis can be missed. We present the case of a 20-year-old female with a TGC in the perianal region. Surgical excision of the cyst was performed, followed by an uneventful recovery. The young age of our patient and the anatomical location of the TGC make our case a rare entity, highlighting the need for practicing surgeons to keep TGC as a differential in mind while examining masses in the perianal region.

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          Retrorectal tumors. Mayo Clinic experience, 1960-1979.

          R Beart, Kathryn Spencer, Eric M. Reiman … (1985)
          One hundred twenty patients with primary retrorectal tumors (79 congenital, 14 neurogenic, 13 osseous, and 14 miscellaneous) had their initial treatment at the Mayo Clinic from 1960 to 1979. The mean age was 43 years (100 patients were adults). Female predominance was associated with congenital cysts (15:1) and male predominance with chordomas (5:1). Forty-three percent of the patients had malignant lesions. No dermoid cysts were found in this series. Diagnosis was made by digital examination or sacral radiographs in all patients. Computed tomography scan was the most important diagnostic method; the rate of positive findings was 100 percent in 20 patients. Approach to the tumor was posterior in 79 of 102 patients in whom resection was possible. Ten of 66 patients with benign tumors had recurrence. The five-year survival rate for patients with chordomas was 75 percent and for patients with other malignant lesions was 17 percent. Because preoperative biopsy can cause tumor spread, abscess, fecal fistula, or meningitis, it should not be performed if tumors are potentially resectable. Whenever possible, total resection should be done.
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            Management of tailgut cysts in a tertiary referral centre: a 10-year experience.

            D Patsouras, N Pawa, H. Osmani … (2015)
            Tailgut cysts are rare congenital lesions typically presenting as presacral masses. A variable clinical presentation often leads to misdiagnosis and unsuccessful operations.
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              Single-center Experience of 24 Cases of Tailgut Cyst

              Ahmad Sakr, Ho Kim, Yoon Dae Han … (2019)
              Purpose Tailgut cysts are rare congenital or developmental lesions that arise from vestiges of the embryological hindgut. They are usually present in the presacral space. We report our single-center experience with managing tailgut cysts. Methods We conducted a retrospective analysis of 24 patients with tailgut cyst treated surgically at the Colorectal Surgery Department of Severance Hospital, Yonsei University, Seoul, South Korea, between 2007–2018. Results This study included 24 patients (18 females) with a median age of 51.5 years (range, 21–68 years). Ten cases were symptomatic and 14 were asymptomatic. Cysts were retrorectal in 21 patients. Cysts were below the coccyx level in 16 patients, opposite the coccyx in 6, and above the coccyx in 2. Cysts were supralevator in 5 patients, had a supra- and infralevator extension in 18 patients, and were infralevator in 1. Ten patients were managed using an anterior laparoscopic approach, 11 using a posterior approach, and 3 using a combined approach. Mean cyst size was 5.5 ± 2.7 cm. Postoperative complications were Clavien-Dindo (CD) classification grade II in 9 patients (37.5%) and CD grade III in 1 (4.2%). The posterior approach group showed the highest rate of complications (P = 0.021). Patients managed using a combined approach showed a larger cyst size (P < 0.001), longer operation times (P < 0.001), and a greater likelihood of tumor level above the coccyx (P = 0.002) compared to other approaches. The tumors of 2 male patients were malignant: 1 was a neuroendocrine tumor treated with radiotherapy, while the other was a closely followed adenocarcinoma. Median follow-up was 12 months (range, 1–66 months) with no recurrence. Conclusion Tailgut cysts are uncommon but can cause perineal or pelvic pain. Complete surgical excision via an appropriate approach according to tumor size, location, and correlation with adjacent pelvic floor muscles is the key treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 31 July 2022
                Publication date (Electronic, collection): July 2022
                Volume: 14
                Issue: 7
                Electronic Location Identifier: e27512
                Affiliations
                [1 ] General Surgery, Benazir Bhutto Hospital, Rawalpindi, PAK
                Author notes
                Article
                DOI: 10.7759/cureus.27512
                PMC ID: 9424791
                SO-VID: d71cb7bc-c6a1-4af0-9a2f-98ae2ff093cb
                Copyright © Copyright © 2022, Arshad et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 31 July 2022
                Categories
                Subject: Gastroenterology
                Subject: General Surgery

                Keywords: perianal cyst,pedunculated mass,perianal lesion,tailgut cyst,surgical case reports
                Data availability:
                Keywords: perianal cyst, pedunculated mass, perianal lesion, tailgut cyst, surgical case reports

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