title: Malignant risk and surgical outcomes of presacral tailgut cysts.
abstract: BACKGROUND
  Presacral tailgut cysts are uncommon and few data exist on the outcomes following surgery.
  
  
  METHODS
  Patients undergoing tailgut cyst resection at the Mayo Clinic between 1985 and 2008 were analysed retrospectively. Demographic data, clinicopathological features, operative details, postoperative complications and recurrence were reviewed.
  
  
  RESULTS
  Thirty-one patients were identified (28 women), with a median age of 52 years. Seventeen patients were symptomatic and 28 had a palpable mass on digital rectal examination. Median cyst diameter was 4.4 cm. Four patients had a fistula to the rectum. Complete cyst excision was achieved in all patients; eight underwent distal sacral resection or coccygectomy. Postoperative complications occurred in eight patients but without 30-day mortality. Malignant transformation was present in four patients: adenocarcinoma in three and carcinoid in one. The cyst recurred in one patient after surgery for a benign lesion.
  
  
  CONCLUSIONS
  Presacral tailgut cysts should be removed due to the risk of malignant transformation.
authors.affiliation: Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Mathis
authors.forename: E J
authors.initials: EJ
authors.lastname: Dozois
authors.forename: M S
authors.initials: MS
authors.lastname: Grewal
authors.forename: P
authors.initials: P
authors.lastname: Metzger
authors.forename: D W
authors.initials: DW
authors.lastname: Larson
authors.forename: R M
authors.initials: RM
authors.lastname: Devine
mesh_terms: D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic; D003560:Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012002:Rectal Diseases / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome