title: Case report: misdiagnosis of tailgut cyst presenting as recurrent perianal fistula with pelvic abscess.
abstract: Tailgut cysts are uncommon lesions that usually occur within the presacral space. The relative rarity and nonspecific complaints associated with these lesions often lead to misdiagnosis or unnecessary procedures before the correct diagnosis is made. We describe a case of a 16-year-old female who presented with pelvic pain. She had previously undergone several procedures at an outside institution for recurrent perianal fistula and perirectal abscess. Subsequent evaluation under anesthesia revealed a presacral cystic mass with a well-developed tract within the anorectal ring in the posterior midline. This mass was surgically removed using a combined transanal and posterior sagittal excision technique and was found to be a tailgut cyst upon pathologic evaluation. Tailgut cysts and other presacral masses should be included in the differential for patients with recurrent abscess in the presacral space or fistula within the anal canal. A variety of surgical approaches are available depending on the anatomy of the lesion.
authors: Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors: Kevin N
authors: KN
authors: Johnson
authors: Tonia M
authors: TM
authors: Young-Fadok
authors: David
authors: D
authors: Carpentieri
authors: Juan M
authors: JM
authors: Acosta
authors: David M
authors: DM
authors: Notrica
mesh_terms: D000038:Abscess / Q000209:etiology*; D000293:Adolescent; D003560:Cysts / Q000150:complications* / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D006222:Hamartoma / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D010388:Pelvis; D012002:Rectal Diseases / Q000150:complications* / Q000175:diagnosis*; D012003:Rectal Fistula / Q000175:diagnosis* / Q000209:etiology*; D012008:Recurrence