Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.1072
Peer-review started: April 23, 2022
First decision: June 19, 2022
Revised: June 30, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 27, 2022
Processing time: 152 Days and 9.4 Hours
Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail. As a congenital disease, caudal cysts are very rare, and their canceration is even rarer, which makes the disease prone to misdiagnosis and delayed treatment. We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990.
A 35-year-old woman found a mass in her lower abdomen 2 mo ago. She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic. Two weeks ago, the patient developed abdominal distension and right waist discomfort and came to our hospital. Except for the high level of serum carcinoembryonic antigen, the medical history and laboratory tests were not remarkable. Magnetic resonance imaging showed a well-defined, slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm × 9 cm in the presacral space, slightly high signal intensity on T2-weighted imaging, and moderate signal intensity on T1-weighted imaging. The mass was completely removed by laparoscopic surgery. Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma, and the multidisciplinary team decided to implement postoperative chemotherapy. The patient recovered well, the tumor marker levels returned to normal, and tumor-free survival has been achieved thus far.
The case and literature summary can help clinicians and researchers develop appropriate exa
Core Tip: Tailgut cysts (TGCs) are rare congenital cysts of the retrorectal space. We report a case of TGC with adenocarcinogenesis and review the literature on caudal cyst adenocarcinogenesis. Magnetic resonance imaging is the most valuable tool for diagnosis and differential diagnosis, and preoperative biopsy is not worth advocating. Early MDT plays an important role in the accurate diagnosis and selection of the most appropriate personalized treatment. Complete resection of TGCs is the key to avoiding postoperative recurrence. We recommend MDT with complete surgical resection as the core and discuss the advantages and disadvantages of various diagnostic and treatment strategies.