Malliou Petra, Syrnioti Antonia, Koletsa Triantafyllia, Karlafti Eleni, Karakatsanis Anestis, Raptou Georgia, Apostolidis Stylianos, Michalopoulos Antonios, Paramythiotis Daniel
The First Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki 54636, Greece.
Department of Pathology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece.
World J Clin Oncol. 2022 Oct 24;13(10):853-860. doi: 10.5306/wjco.v13.i10.853.
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.
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.
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.
直肠后错构瘤或尾肠囊肿(TCs)较为罕见。多数情况下,它们无症状且为良性;然而,极少数会发生恶性转化,主要表现为腺癌。
一名55岁女性因下背部疼痛前来我院就诊。磁共振成像检查发现盆腔有一个大肿块,位于坐骨直肠窝右侧,延伸至小骨盆。患者通过右臀部接受了病变的广泛手术切除。组织学检查确诊为起源于尾肠囊肿的直肠后黏液腺癌。肿瘤手术切除完整,患者康复且无并发症。随后切除了藏毛窦。一年后,半年一次的正电子发射断层扫描 - 计算机断层扫描和磁共振成像扫描未发现局部复发或转移性疾病的任何迹象。
尾肠囊肿的术前识别、组织学诊断和治疗面临重大挑战。此外,虽然罕见,但应考虑发生侵袭性黏液腺癌的可能性。