title: [Adenocarcinoma in a tail-gut cyst: a rare cause of recurrent perianal fistula].
abstract: A 58-year-old woman was initially externally diagnosed in 1983 with a presacral mass, which was subsequently treated as an abscess. Thereafter, the patient experienced recurrent perianal fistulas. Further diagnostic studies revealed a cystic tumor, considered to be an epidermoid cyst, which was located in the inferior pelvis and was consequently removed. Histologically, cystic scar tissue was found with a highly differentiated adenocarcinoma which measured 4 cm. Later on, the patient again experienced perianal fistulas originating from a renewed presacral mass. As a result, an abdominal-perianal rectum extirpation and a partial resection of the sacrum with placement of a descendostomy were done. Histologically, adenocarcinoma tissue was found at the base of a tail-gut cyst. One year following her operation, the patient is free from any complaints and relapses. The tail-gut cyst is a very rare entity which arises from the inadequate involution of the tail-gut during embryonal development. A malignant transformation occurs in 10% of the cases. In the case of recurrent perianal fistulas and cystic masses between the rectum and os sacrum or os coccygeum, a tail-gut cyst should be taken into consideration, the goal being its complete removal.
authors.affiliation: Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz. joerg_sauer@gmx.net
authors.forename: J
authors.initials: J
authors.lastname: Sauer
authors.forename: H K
authors.initials: HK
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Junginger
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D012003:Rectal Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000473:pathology; D012008:Recurrence; D014057:Tomography, X-Ray Computed