Hufkens Ann-Sophie, Cools Peter, Leyman Paul
a Department of General and Abdominal Surgery , GZA Hospitals, Campus Sint-Vincentius , Antwerp , Belgium.
b Department of General and Abdominal Surgery , GZA Hospitals, Campus Sint-Augustinus , Wilrijk , Belgium.
Acta Chir Belg. 2019 Apr;119(2):110-117. doi: 10.1080/00015458.2017.1353758. Epub 2019 Feb 18.
Tailgut cysts or retrorectal cystic hamartomas are congenital developmental lesions which are often misdiagnosed due to their rare incidence, anatomical position and variable clinical presentation.
We report three clinical cases: one of a 67-year old woman with high fever and anal bulging; the second case was a 50-year old woman with diffuse abdominal pain and the third case was a 52-year old woman with high fever and no abdominal or rectal pain. The rectal examination and MRI indicated the presence of a tailgut cyst. In all the cases a complete resection through a posterior perineal route was performed. Histopathological examination confirmed the diagnosis of a tailgut cyst, with a malignant component identified in the third case.
The discussion presents a brief review of the relevant information described in the literature to highlight the cornerstones for appropriate diagnosis and treatment of a tailgut cyst. Tailgut cysts are to be considered in the differential diagnosis of retrorectal or presacral masses as malignant transformation can occur.
尾肠囊肿或直肠后囊性错构瘤是先天性发育性病变,因其发病率低、解剖位置特殊及临床表现多样,常被误诊。
我们报告三例临床病例:第一例为一名67岁女性,伴有高热和肛门坠胀感;第二例为一名50岁女性,伴有弥漫性腹痛;第三例为一名52岁女性,伴有高热但无腹部或直肠疼痛。直肠检查和磁共振成像(MRI)显示存在尾肠囊肿。所有病例均通过后会阴途径进行了完整切除。组织病理学检查确诊为尾肠囊肿,第三例病例中发现了恶性成分。
讨论部分简要回顾了文献中描述的相关信息,以突出尾肠囊肿正确诊断和治疗的关键要点。在直肠后或骶前肿块的鉴别诊断中应考虑尾肠囊肿,因为其可能发生恶变。