A Surgical Case of Tailgut Cyst

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  • Shibao K.
    Department of Surgery I, University of Occupational and Environmental Health
  • Nakayama Y.
    Department of Surgery I, University of Occupational and Environmental Health
  • Hirata K.
    Department of Surgery I, University of Occupational and Environmental Health
  • Nagata N.
    Department of Surgery I, University of Occupational and Environmental Health
  • Itoh H.
    Department of Surgery I, University of Occupational and Environmental Health

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  • Ｔａｉｌｇｕｔ　ｃｙｓｔの１手術例

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Abstract

We report a case of tailgut cyst arising from a presacral lesion. A 52-year-old woman presented at the hospital because of tarry stool. CT scan and magnetic resonance imaging scan showed a cystic mass in the presacral lesion. No tumor marker, such as CEA, CA19-9, or CA125, was elevated. With a pre-operative diagnosis of cystic mass in the presacral space, a complete excision through a trans-sacral approach with coccyx resection was performed. The resected specimen was a smooth-walled, biloculated cyst measuring 13.5×10×6 cm and 3×2×5 cm, respectively. The cyst contained a dark yellowish green fluid. Microscopic exami-nation revealed that the cyst wall consisted of squamous, villous, and columnar epithelia with bundles of smooth muscle conforming to the periphery of the cyst. The mass was diagnosed as tailgut cyst. No evidence of malignancy was found. The addition of coccyx resection to the traps-sacral approach made it easier to keep the surgical site in a good state for completely resecting the tailgut cyst. In Japan, two cases of malignancy have been reported, one of which was a recurrent case arising from remnant cyst after primary surgery for tailgut cyst. Tailgut cysts should be excised completely and need careful follow-up after surgery.

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