TITLE:
Double tailgut cysts (presacral and precoccygeal hamartomas) with CA 19-9 elevation
AUTHORS:
Ji Won Kim, Jae Woong Han, So Young Jung, Seung Chul Lee, Byung Chun Kim, Hye Kyung Ahn, Han Myun Kim
KEYWORDS:
Tailgut Cyst; Retrorectal Hamartoma; Presacral Tumor; Retrorectal Tumor; Retrectal Developmental Cysts
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.1,
March
7,
2013
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.