Tailgut cysts: diagnostic challenge for both pathologists and clinicians

Excerpt

Retrorectal area is a well-known space for the presence of some familiar lesions, like “sacrococcygeal teratoma” in children and a low-grade malignant tumor called “chordoma” in adults. However, a variety of congenital, inflammatory, and neoplastic lesions can occur in this area, but not famous enough to the practicing pathologist to be easily familiar with. Retrorectal cystic hamartoma or “tailgut cyst” is one of them. It is a benign, developmental lesion. In addition to its nonspecific and misleading clinical presentation, it can also confuse the pathologist while giving the definitive diagnosis. Patients who had multiple, unnecessary operations before the correct diagnosis was made had been reported in the literature. The largest series of 53 cases was collected over a 35-year period by Hjermstad and Helwig at the Armed Forces Institute of Pathology, Washington, DC, USA. Unfortunately, 51 out of 53 cases were not given the correct initial diagnosis of tailgut cyst. However, most of the pathologists were aware of that they were dealing with a benign, congenital, cystic process but had difficulty in further classifying it. …