A large presacral tailgut cyst with a carcinoid tumor in a male: report of a case

Abstract

Tailgut cysts are developmental hamartomas found in the presacral space. They are usually detected incidentally during physical examinations or imaging studies. However, they may cause symptoms due to compression of nearby organs. Due to their potential malignant transformation, surgical resection is warranted, while routine biopsy is considered controversial because of the concern about infection of the tailgut cyst and needle-track implantation of malignant cells. The co-existence of a carcinoid in a tailgut cyst is extremely rare. Only 16 cases have been reported previously, the vast majority of which were found in females. We herein present the case of a carcinoid in a tailgut cyst found in a male patient, discuss the potential pathogenesis of tailgut carcinoids, and underline the fact that their previous consideration of the condition as a female-restricted entity should be rejected.

Excision of Retrorectal Tumors: Comparing Outcome Regarding Surgical Approach

“…However, it is important to keep in mind that cystic lesions with solid walls and heterogeneous components have a higher chance of malignancy. 9,10,11 In our study, 79.3% of the cases were benign. It was found that one of the malignant cases occurred based on tailgut cysts.…”

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

“…Neuroendocrine tumours represented 20 cases (39% of all tumours found). Of these, 15 [2,33,36,47,49,53,64,70,93,106,107,115,123,131] were reported either as neuroendocrine carcinomas or metastatic at the time of presentation. There was one case of neuroendocrine tumour arising in a tailgut cyst which was treated by abdominoperineal resection but the patient later went on the develop liver and brain metastasis [107].…”

Management approach and surgical strategies for retrorectal tumours: a systematic review

“… reported three of seven benign appearing cysts misdiagnosed by preoperative biopsy. There have been cases of what was deemed initially to be a benign presacral cyst found on the final pathology to contain adenocarcinoma and carcinoid . There have been around 16 cases of carcinoid within a tailgut cyst described in the literature .…”

“…The current study showed that retrorectal tumours are more likely to be benign. Cystic lesions are mostly benign, except in cases where solid wall or heterogeneous components are demonstrated on imaging . A preoperative biopsy should not be performed for a cystic retrorectal lesion.…”