Maruyama A, Murabayashi K, Hayashi M, Nakano H, Isaji S, Uehara S, Kusuda T, Miyahara S, Kondo A, Nakano H, Yabana T
Department of Surgery, Yamada Red Cross Hospital, Mie, Japan.
Surg Today. 1998;28(12):1319-22. doi: 10.1007/BF02482826.
We report herein the unusual case of a 66-year-old woman found to have adenocarcinoma arising in a tailgut cyst. The patient had been observed for 6 months following the discovery of a presacral cystic mass measuring 10 x 9 cm for which she had refused surgery. The serum tumor marker, carcinoembryonic antigen, became slightly elevated, and diagnostic imaging distinctly revealed a tumorous lesion with papillary projection into the cyst lumen. The cystic mass was then excised through the transsacral approach. The pathological findings were compatible with moderately differentiated adenocarcinoma arising in a tailgut cyst. This entity is extremely rare, and only six cases, including our own, have been reported in the English literature. Early complete excision is advised because it is almost impossible to determine for certain whether presacral cystic masses are benign or malignant prior to surgery.
我们在此报告一例罕见病例，一名66岁女性被发现患有起源于尾肠囊肿的腺癌。患者在发现骶前有一个10×9厘米的囊性肿块后，已观察6个月，她拒绝了手术。血清肿瘤标志物癌胚抗原略有升高，诊断性影像学检查清楚地显示出一个肿瘤性病变，有乳头状突起伸入囊肿腔内。然后通过经骶骨入路切除了囊性肿块。病理结果与起源于尾肠囊肿的中分化腺癌相符。这个实体极其罕见，英文文献中仅报道了包括我们这例在内的6例。建议早期完整切除，因为在手术前几乎不可能确定骶前囊性肿块是良性还是恶性。
