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Case Reports
. 2022 Oct 24;13(10):853-860.
doi: 10.5306/wjco.v13.i10.853.

Mucinous adenocarcinoma arising from a tailgut cyst: A case report

Petra Malliou  1 , Antonia Syrnioti  2 , Triantafyllia Koletsa  2 , Eleni Karlafti  3 , Anestis Karakatsanis  4 , Georgia Raptou  2 , Stylianos Apostolidis  4 , Antonios Michalopoulos  4 , Daniel Paramythiotis  4
Affiliations
Case Reports

Mucinous adenocarcinoma arising from a tailgut cyst: A case report

Petra Malliou et al. World J Clin Oncol. .

Abstract

Background: Retrorectal hamartomas or tailgut cysts (TCs) are rare. In most cases, they are asymptomatic and benign; however, rarely, they undergo malignant transformation, mainly in the form of adenocarcinoma.

Case summary: A 55-year-old woman presented to our hospital with lower back pain. On magnetic resonance imaging, a large pelvic mass was found, which was located on the right of the ischiorectal fossa, extending to the minor pelvis. The patient underwent extensive surgical resection of the lesion through the right buttock. Histological examination confirmed the diagnosis of a retrorectal mucinous adenocarcinoma originating from a TC. Surgical resection of the tumour was complete, and the patient recovered without complications. The pilonidal sinus was then excised. One year later, semi-annual positron emission tomography-computed tomography and magnetic resonance imaging scans did not reveal any evidence of local recurrence or metastatic disease.

Conclusion: Preoperative recognition, histological diagnosis, and treatment of TCs pose significant challenges. In addition, the possibility of developing invasive mucinous adenocarcinoma, although rare, should be considered.

Keywords: Case report; Mucinous adenocarcinoma; Mucosal tumour; Pilonidal cyst; Retrorectal tumour; Tailgut cyst.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging. A and C: Coronal and axial planes of the mass with smooth borders, lobed on the upper side with a beak sign. Cystic and solid elements, septa, and haemorrhagic and protein elements. It absorbs paramagnetic substance; B and D: Computed tomography scan - Coronal and axial planes of the mass. Differential diagnosis of tail gut cyst or cystic teratoma (arrows).
Figure 2
Figure 2
Patient underwent extensive surgical resection of the lesion through the right buttock. A: Preoperative view of the mass (arrow); B and C: Extensive surgical resection of the lesion through the right buttock; D: Removed mass.
Figure 3
Figure 3
Microscopic examination confirmed the presence of a cystic mass that comprised thick fibrous bands that divided it into three cystic spaces, the largest of which corresponded to mucinous adenocarcinoma. A: Fibrous tissue separates two cystic spaces, one benign lined by keratinized squamous cell epithelium and the other corresponding to mucinous adenocarcinoma; B-D: Higher magnification of mucinous adenocarcinoma that is immunohistochemically positive (IHC-positive) for antibodies CK20 and CK7; E and F: A smaller cystic space with fibromuscular wall lined by keratinized squamous epithelium and partially by pseudostratified ciliated columnar epithelium (arrow) is observed. Section of the pilonidal cyst (arrow: Hair shaft). [A: Hematoxylin-eosin staining (HE), magnification × 40; B: HE × 100; C: IHC × 20; D: IHC × 100; E and F: HE × 40].
See this image and copyright information in PMC

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