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

Ji Won Kim, Jae Woong Han, So Young Jung, Seung Chul Lee, Byung Chun Kim, Hye Kyung Ahn, Han Myun Kim

Departments of Pathology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Departments of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Departments of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

DOI: 10.4236/crcm.2013.21002                

Abstract

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.

Keywords

Tailgut Cyst; Retrorectal Hamartoma; Presacral Tumor; Retrorectal Tumor; Retrectal Developmental Cysts

Conflicts of Interest

The authors declare no conflicts of interest.

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