Doctor of Medicine, Department of Internal Medicine, College of Medicine Soonchunhyang University Hospital, Seoul, Korea.
Scott Med J. 2014 Feb;59(1):e14-7. doi: 10.1177/0036933013519029. Epub 2014 Jan 16.
A 49-year-old man was referred with constipation that had lasted for a few months. On colonoscopy, a subepithelial tumour more than 4 cm in size was seen in the rectum. He underwent endoscopic ultrasound and pelvic magnetic resonance imaging. He was preoperatively diagnosed with a rectal duplication cyst based on imaging studies. However, the final histopathologic diagnosis after transanal excision of the rectal mass was rectal carcinoid tumour with tailgut cyst. Tailgut cysts are very rare congenital lesions in the presacral area and are most often discovered incidentally in middle-aged women. It is difficult to distinguish the imaging appearance of tailgut cysts from that of many other retrorectal cysts. Malignant transformation of tailgut cysts has been estimated to occur in 2 to 13% of cases. We report the diagnostic difficulties encountered in a case of carcinoid tumour arising from a tailgut cyst in a male patient.
一位 49 岁男性因持续数月的便秘就诊。结肠镜检查发现直肠内有一个大小超过 4cm 的黏膜下肿瘤。他接受了内镜超声和盆腔磁共振成像检查。术前根据影像学检查诊断为直肠重复囊肿,但直肠肿块经肛门切除术后的最终组织病理学诊断为直肠类癌伴尾肠囊肿。尾肠囊肿是一种非常罕见的先天性骶前区病变,多在中年女性中偶然发现。很难将尾肠囊肿的影像学表现与许多其他直肠后囊肿区分开来。尾肠囊肿的恶性转化率估计为 2%至 13%。我们报告了一例男性患者的尾肠囊肿发生类癌时遇到的诊断困难。