Retrorectal cystic hamartoma: A problematic ′Tail′

Abstract

The retrorectal space is an uncommon seat for neoplastic masses. Retrorectal hamartoma or tailgut cyst (TGC) is an uncommon developmental cystic lesion occurring in this space which mostly occurs in middle-aged females. We recently cared for a 16-year-old girl who presented with vague lower abdominal pain and occasional constipation. Per rectal examination revealed an extraluminal mass bulging from posterior rectal wall. Preoperative radiological investigations revealed by suggested it to be a mature cystic teratoma. The patient underwent exploratory laprotomy with en masse excision of the cyst. Histopathological examination of the specimen showed it to be a TGC. This case highlights the possibility of a TGC as a differential for retrorectal cystic lesions and the need to completely excise them given the possibility of future malignant transformation.

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

“…The eligible papers and Table give a good impression of the typical case. The relative risk for malignant transformation was raised in the case of finding nodular thickening of the cyst wall on radiology ( P = 0.0023).…”

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

“…Tailgut cysts can contain a variety of epithelia between cysts or in the same cyst, such as stratified squamous epithelium, and transitive, mucinous, ciliated columnar, and cubic mucous epithelia [18][19][20]. Although these cysts are usually benign, infections and fistulas may be the consequence of malignancy and not the cause [20].…”

Retrorectal cystic hamartoma: A case report

“…The retrorectal region is a potential space that may develop in the presence of a mass which is delimited superiorly by pelvic peritoneal reflection, inferiorly by the coccygeal and elevator muscles of the anus, anteriorly by the rectum, posteriorly by the sacrum and the coccyx and laterally by the iliac vessels, and ureters [1,2,4]. The differential diagnosis of masses that can develop in this area is vast and includes primary tumors of neurogenic, osteogenic and congenital origin, and inflammatory and metastatic secondary processes.…”

“…Pre-sacred hamartomas can be a source of perirectal www.casereportsinternational.com Viveiros et al 6 or perianal chronic symptoms and are often difficult to recognize and diagnose. Also, treatment is often poorly oriented, submitting the patient to multiple surgeries before a definitive diagnosis can be obtained [2,3].…”