Double tailgut cysts (presacral and precoccygeal hamartomas) with CA 19-9 elevation


Tailgut cyst, also called retrorectal hamartoma, is a rare congenital lesion and is usually located anterior to the sacrum and posterior to the rectum. We report a case of double tailgut cyst (presacral and precoccygeal hamartoma). A 62-year- old female visited the hospital complaining of anal pain and pressure in the perianal area for one month. Digital rectal examination revealed a round mass with hard consistency in the lateral and posterior part of rectum 5 cm from the anal verge. Pelvic magnetic resonance imaging showed two cystic and solid presacral masses (lateral and posterior part of rectum) compressing the rectum. The patient underwent surgical resection for pathologic diagnosis. At operation, two masses were located in the left presacral space without invasion to adjacent organs and soft tissue. Pathologic examination revealed double tailgut cysts without malignant transformation. A differential diagnosis of perirectal cystic hamartoma includes epidermal cysts, cystic teratomas, dermoid cysts, anal gland cysts, sarcoma and rectal duplications. Regional inflammatory process frequently complicates this lesion and perirectal fistula can develop. Tailgut cyst also has a malignancy potential, with development of adenocarcinomas. To establish a definite diagnosis and prevent complication, complete surgical resection is recommended.

Share and Cite:

Kim, J. , Han, J. , Jung, S. , Lee, S. , Kim, B. , Ahn, H. and Kim, H. (2013) Double tailgut cysts (presacral and precoccygeal hamartomas) with CA 19-9 elevation. Case Reports in Clinical Medicine, 2, 5-8. doi: 10.4236/crcm.2013.21002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Gips, M., Melki, Y. and Wolloch, Y. (1994) Cysts of the tailgut. Two cases. European Journal of Surgery, 160, 459-460.
[2] Jang, S.H., Jang, K.S., Song, Y.S., Min, K.W., Han, H.X., Lee, K.G. and Paik, S.S. (2006) Unusual prerectal location of a tailgut cyst: A case report. World Journal of Gastroenterology, 12, 5081-5083.
[3] Tampi, C., Lotwala, V., Lakdawala, M. and Coelho, K. (2007) Retrorectal cyst hamartoma (tailgut cyst) with malignant transformation. Gynecologic Oncology, 105, 266268. doi:10.1016/j.ygyno.2007.01.008
[4] Dahan, H., Arrivé, L., Wendum, D., Docou le Pointe, H., Djouhri, H. and Tubiana, J.M. (2001) Retrorectal developmental cysts in adults: clinical and radiologi-histopathologic review, differential diagnosis, and treatment. Radiographics, 21, 575-584.
[5] Hutton, K.A. and Benson, E.A. (1992) Case report: Tailgut cyst-assesment with transrectal ultrasound. Clinical Radiology, 45, 288-289. doi:10.1016/S0009-9260(05)80020-0
[6] Au, E., Anderson, O., Morgan, B., Alarcon, L. and George, M.L. (2009) Tailgut cysts: Report of two cases. International Journal of Colorectal Disease, 24, 345-350. doi:10.1007/s00384-008-0598-6
[7] Hjermstad, B.M. and Helwig, E.B. (1988) Tailgut cysts. Report of 53 cases. American Journal of Clinical Pathology, 89,139-147.
[8] Gonul, I.I., Baglan, T., Pala, I. and Mentes, B. (2007) Tailgut cysts: Diagnostic challenge for both pathologists and clinicians. International Journal of Colorectal Diseases, 22, 1283-1285. doi:10.1007/s00384-006-0153-2
[9] Aflalo-Hazan, V., Rousset, P., Mourra, N., Lewin, M., Azizi, L. and Hoeffel, C. (2008) Tailgut cysts: MRI findings. European Radiology, 18, 2586-2593. doi:10.1007/s00330-008-1028-4
[10] Yang, D.M., Park, C.H., Jin, W., Chang, S.K., Kim, J.E., Choi, S.J. and Jung, D.H. (2005) Tailgut cyst: MRI evaluation. American Journal of Roentgenology, 184, 15191523. doi:10.2214/ajr.184.5.01841519
[11] Singer, M.A., Cintron, J.R., Martz, J.E., Schoetz, D.J. and Abcarian, H. (2003) Retrorectal cyst: A rare tumor frequently misdiagnosed. Journal of the American College of Surgeons, 196, 880-886. doi:10.1016/S1072-7515(03)00133-9
[12] Schwarz, R.E., Lyda, M., Lew, M. and Paz, I.B. (2000) A carcinoembryonic antigen-secreting adenocarcinoma arising within a retrorectal tailgut cyst: Clinicopathological considerations. American Journal of Gastroenterology, 95, 1344-1347. doi:10.1111/j.1572-0241.2000.02023.x
[13] Maruyama, A., Murabayashi, K., Hayashi, M., Nakano, H., Isaji, S., Uehara, S., Kusuda, T., Miyahara, S., Kondo, A., Nakano, H. and Yabana, T. (1998) Adenocarcinoma arising in a tailgut cyst: Report of a case. Surgery Today, 28, 1319-1322. doi:10.1007/BF02482826
[14] Sriganeshan, V. and Alexis, J.B. (2006) A 37-year-old woman with a presacral mass. Tailgut cyst (retrorectal cystic hamartoma). Archives of Pathology & Laboratory Medicine, 130, 77-78.
[15] Glasgow, S.C., Birnbaum, E.H., Lowney, J.K., Fleshman, J.W., Kodner, I.J., Mutch, D.G., Lewin, S., Mutch, M.G. and Dietz, D.W. (2005) Retrorectal tumors: A diagnostic and therapeutic challenge. Diseases of the Colon & Rectum, 48, 1581-1587. doi:10.1007/s10350-005-0048-2
[16] Buchs, N., Taylor, S. and Roche, B. (2007) The posterior approach for low retrorectal tumors in adults. International Journal of Colorectal Diseases, 22, 381-385. doi:10.1007/s00384-006-0183-9
[17] Zoller, S., Joos, A., Dinter, D., Back, W., Horisberger, K., Post, S. and Palma, P. (2007) Retrorectal tumors: Excision by transanal endoscopic microsurgery. Revista Espanola de Enfermedades Digestivas, 99, 547-550. doi:10.4321/S1130-01082007000900011

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.