Krivokapic Zoran, Dimitrijevic Ivan, Barisic Goran, Markovic Velimir, Krstic Miodrag
FRCS, First Surgical Clinic, Koste Todorovica 6, Belgrade 11000, Serbia and Montenegro.
World J Gastroenterol. 2005 Oct 21;11(39):6225-7. doi: 10.3748/wjg.v11.i39.6225.
Retrorectal, developmental tail gut cysts, include dermoid cysts, rectal duplication cysts and retrorectal cyst-hamartomas. Retrorectal cyst-hamartomas (RCH) are derived from remnants of the tail gut, the most caudal part of the embryonic hind gut, which normally involutes by the 8(th) wk of embryonic development (3-8 mm stage). They have specific radiological and histopathological features that distinguish them from other similar formations (dermoid cysts, enteric duplication cysts and teratomas). We report a patient with adenosquamous carcinoma arising within RCH, who underwent complete resection of the cyst through anterior laparotomy, and reached complete (recurrence-free for 14 mo, so far) functional recovery. The cyst was incidentally discovered during hysterectomy 12 years ago. Diagnostic, therapeutic and histopathological aspects of this rare case are discussed. The mentioned period between diagnosis and surgical treatment suggests that RCH, given enough time, can develop malignant degeneration, and should be resected at the time of diagnosis.
直肠后发育性尾肠囊肿包括皮样囊肿、直肠重复囊肿和直肠后囊肿性错构瘤。直肠后囊肿性错构瘤（RCH）起源于尾肠残余，即胚胎后肠最尾端部分，通常在胚胎发育第8周（3 - 8毫米阶段）退化。它们具有特定的放射学和组织病理学特征，使其与其他类似病变（皮样囊肿、肠重复囊肿和畸胎瘤）相区别。我们报告1例RCH内发生腺鳞癌的患者，该患者通过前入路剖腹手术完整切除囊肿，并实现完全（截至目前无复发14个月）功能恢复。该囊肿于12年前子宫切除术中偶然发现。本文讨论了该罕见病例的诊断、治疗及组织病理学方面。诊断与手术治疗之间的上述间隔表明，RCH若给予足够时间可发生恶性变，应在诊断时切除。
