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

Feng, Lei; Li, Jian; Yu, Ke; Zhang, Kai; Liu, Tongjun; Li, Jiannan

doi:10.12659/msm.919803

Cited by 24 publications

(61 citation statements)

References 68 publications

(85 reference statements)

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“…Based on the anatomical site of the TGCs, there are 4 main surgical approaches, including the sacrococcygeal approach, the single abdominal approach, the combined sacrococcygeal approach, and the anal approach. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…The 3 most common types of malignant transformations in TGCs are neuroendocrine tumor, adenocarcinoma, and squamous carcinoma. [ 16 ] For TGCs with malignant transformation, post-surgical adjuvant therapy is suggested to kill the residual tumor tissues and improve patient prognosis. [ 16 ] For TGCs with neuroendocrine tumor transformation, the administration of postoperative somatostatin might improve patient prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…[ 16 ] For TGCs with malignant transformation, post-surgical adjuvant therapy is suggested to kill the residual tumor tissues and improve patient prognosis. [ 16 ] For TGCs with neuroendocrine tumor transformation, the administration of postoperative somatostatin might improve patient prognosis. [ 17 ] In addition, tyrosine kinase inhibitors and an oral mechanistic target of rapamycin inhibitors have been found to increase patients’ progression-free survival of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[ 18 ] For TGCs with adenocarcinoma and squamous carcinoma transformation, surgical resection followed by radiotherapy and chemotherapy is still the main treatment method. [ 16 ] However, few cases of TGCs with malignant transformation are reported; therefore, the metastatic potential of TGCs with malignant transformation is unclear.…”

Section: Discussionmentioning

confidence: 99%

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Tailgut cyst with adenocarcinoma transition

Wang¹,

Liu²,

Mu³

et al. 2020

Medicine

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Rationale: Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare. Patient concerns: A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day. Diagnosis: Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0–3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0–35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition. Interventions: The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well. Lessons: We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Tailgut cyst with adenocarcinoma transition

Wang¹,

Liu²,

Mu³

et al. 2020

Medicine

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“…Pathologically, the proportions of NETs and tailgut cysts in each lesion are variable. Therefore, the lesions may be solid, cystic, or a mixture of both [13,15]. NETs arising from tailgut cysts were positive on immunostaining for SSTR2a, as well as primary NETs.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic resection of a neuroendocrine tumor that almost fully replaced tailgut cysts: a case report

et al. 2020

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Background Neuroendocrine tumors (NETs) originate from neuroendocrine cells, which are found throughout the body. NETs occur principally in the gastrointestinal tract (approximately 65%) and bronchopulmonary tract (approximately 25%) but rarely occur in the presacral space. Aside from primary and metastatic lesions, there have been reports of NETs occurring in the presacral space arising from tailgut cysts, teratomas, and imperforate anus. We herein report a rare case of laparoscopic resection of a NET in the presacral space, which almost fully replaced tailgut cysts. Case presentation A 68-year-old woman was referred to our hospital for surgery of a right inguinal hernia, but preoperative computed tomography revealed an asymptomatic 43-mm mass in the presacral space. Magnetic resonance imaging showed a multilocular solid mass with clear boundaries and a slightly high signal intensity on T1- and T2-weighted images. Positron emission tomography showed 18F-fluorodeoxyglucose uptake. Thus, we suspected a malignant tumor and performed laparoscopic resection to obtain a definitive diagnosis. Macroscopically, the tumor was 43 mm in size with clear boundaries, and the cut surface was a gray-white solid component. Histopathological findings revealed that the tumor was composed of relatively uniform cells with fine chromatin, with round to oval nuclei arranged in solid, trabecular, or rosette-like growth patterns. Small cysts lined with stratified squamous epithelium and columnar epithelium were observed along with solid components of the tumor, which is a feature of tailgut cysts. Therefore, the final diagnosis was NET Grade 1 arising from tailgut cysts. No recurrence was observed within 1 year after surgery. Conclusions We performed en bloc laparoscopic resection of a NET arising from tailgut cysts in the presacral space without injury. In cases of a solid lesion in the presacral space, not only the primary disease but also the pathological condition with tissue transformation and replacement should be considered, as in this case.

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