title: Laparoscopic resection of tailgut cysts: the size is not the issue.
abstract: BACKGROUND
  Tailgut cysts are rare retrorectal cystic lesions usually treated by surgical resection, even where asymptomatic, due to the risk of malignancy and recurrence. In the last 20 years, the laparoscopic abdominal approach has been gaining consensus for its better visualization of pelvic structures and minimal invasiveness.
  
  
  METHODS
  We present the case of the biggest tailgut cysts managed laparoscopically reported so far.
  
  
  CONCLUSIONS
  Mostly asymptomatic, diagnosis of tailgut cysts is often fortuitous during routine examination. Their malignant transformation is estimated being 14.1% of cases. MRI is particularly indicated to lead the surgical approach, given its superior resolution in soft tissues and assessment of local invasion. Surgical resection is the therapy of choice, performed with different approaches: the laparoscopic abdominal technique, performed by surgeons with expertise in pelvic laparoscopic surgery, allows the best visualization of pelvic viscera with lesser morbidity. Due to rupture and seeding risks, the laparoscopic approach should not be performed if there is any suspicion of malignancy.
  
  
  CONCLUSIONS
  Our case substantiates safety and feasibility of laparoscopic tailgut cysts management, even of large-size cysts. Preoperative imaging is crucial to assess the possible malignancy of the lesion and, in that case, to perform a laparotomic approach.
  
  
  BACKGROUND
  Laparoscopy, Retrorectal space, Tailgut Cyst.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Dalmonte
authors.forename: Francesco
authors.initials: F
authors.lastname: Tartamella
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Mita
authors.forename: Giuseppina
authors.initials: G
authors.lastname: De Sario
authors.forename: Luigi
authors.initials: L
authors.lastname: Roncoroni
authors.forename: Federico
authors.initials: F
authors.lastname: Marchesi
mesh_terms: D000368:Aged; D003560:Cysts / Q000151:congenital / Q000601:surgery*; D006222:Hamartoma / Q000151:congenital / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012187:Retroperitoneal Space