Squamous cell carcinoma arising in a sacrococcygeal tailgut cyst

Abstract

We report a case of squamous cell carcinoma originated from a sacrococcygeal tailgut cyst in a 73-year-old female patient. Tailgut cysts are generally multilocal and have a layer of either columnar, squamous or transitional epithelium, or a combination of these. This case was treated with surgical excision and radiotherapy. Cancer presentation of a congenital abnormality in old age is a rare entity. This report is the first case of squamous cell carcinoma developing in a tailgut cyst without any synchronization, as an isolated (pure) pathology.

Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review

“…25 Although TGCs could present at any age, they predominantly occur in middle-aged women, whereas their incidence in children remains low. 26 In accordance to our findings, a 3:1 (female:male) sex ratio is reported in the majority of published studies. 2,5 Concerning the clinical presentation of TGC affected patients, they usually present with atypical symptoms, caused either by local pressure to the surrounding structures or by infection or malignant transformation of the presacral cyst.…”

Tailgut Cysts with Malignant Transformation: Features, Diagnosis, and Treatment

“…The tumor consists of atypical and normal squamous cells and shows keratinization in solid masses. Furthermore, the tumor can also invade subcutaneous adipose tissue and skeletal muscle tissue [60]. Histopathological findings of tailgut cysts with squamous carcinoma transition comprise stratified squamous epithelium and columnar epithelium.…”

“…The current trend is to retain the coccyx, unless the malignant tumors require whole excision or the cysts adhere closely to the coccyx [66]. The surgical approach is based on the anatomical site [60]. There are 4 accepted methods of surgical approach, including the sacrococcygeal approach, the single abdominal approach, the combined sacrococcygeal approach, and the anal approach.…”

Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature

“…It seems reasonable to exclude those cases where there was evidence of invasion of the spinal canal and in some cases even tethering of the spinal cord in association with pre-sacral cysts, since these violate the embryological planes respected by all other enteric structures. However, we found only five such cases [137,[140][141][142]145], one of which also had inferior vena cava duplication and uterine didelphys [141]. We are anxious to exclude these cases because a true ontogenic explanation for them does not exist.…”