Wang YS, Guo QY, Zheng FH, Huang ZW, Yan JL, Fan FX, Liu T, Ji SX, Zhao XF, Zheng YX. Retrorectal mucinous adenocarcinoma arising from a tailgut cyst: A case report and review of literature. World J Gastrointest Surg 2022; 14(9): 1072-1081 [PMID: 36185552 DOI: 10.4240/wjgs.v14.i9.1072]
Corresponding Author of This Article
Yi-Xiong Zheng, MD, Attending Doctor, Professor, Department of General Surgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, No. 1 Shangcheng Road, Yiwu 322000, Zhejiang Province, China. 2100011@zju.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yan-Shuai Wang, Fang-Hong Zheng, Zi-Wei Huang, Jia-Lang Yan, Fu-Xiang Fan, Yi-Xiong Zheng, Department of General Surgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China
Qing-Yun Guo, Xiao-Feng Zhao, Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Tian Liu, Department of Intensive Care Unit, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China
Shun-Xian Ji, Department of Pathology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China
Author contributions: Wang YS and Guo QY contributed to the conceptualization; Zheng FH, Huang ZW, and Yan JL contributed to the literature search and data analysis; Wang YS wrote the original draft; Fan FX, Liu T, and Ji SX reviewed and edited the manuscript; Zheng YX and Zhao XF supervised the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Xiong Zheng, MD, Attending Doctor, Professor, Department of General Surgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, No. 1 Shangcheng Road, Yiwu 322000, Zhejiang Province, China. 2100011@zju.edu.cn
Received: April 23, 2022 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.
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.
