Two Cases of Symptomatic Tailgut Cysts

Area of Science:

• Gastroenterology
• Surgical Oncology
• Gynecologic Oncology

Background:

• Tailgut cysts are rare, benign lesions originating from the terminal hindgut, typically found in the rectorectal space.
• While often asymptomatic, they can cause symptoms due to mass effect on adjacent organs and nerves.
• These cysts predominantly affect females aged 30-60, with a variable, though generally low, risk of malignancy.

Observation:

• Two symptomatic cases of tailgut cysts are presented, emphasizing their rarity and diverse clinical presentations.
• Case 1 involved a large cyst causing tenesmus, urinary dysfunction, and dysmenorrhea, managed with laparotomy and a combined approach.
• Case 2 presented with a cyst co-existing with endometriosis, leading to sacral pain, constipation, and tenesmus, treated with a Kraske approach and coccygectomy due to bone infiltration and cyst perforation.

Findings:

• Successful surgical excision of both tailgut cysts and involved coccyx bone was achieved using distinct surgical strategies tailored to cyst morphology and location.
• The study underscores the importance of varied surgical approaches, including laparotomy and the Kraske procedure, for managing complex tailgut cyst cases.
• Post-operative follow-up included regular surgical check-ups and MRI scans to monitor patient recovery and detect any recurrence.

Implications:

• This case series contributes valuable insights into the diagnosis and surgical management of rare tailgut cysts, offering practical knowledge for clinicians.
• Understanding the varied symptoms and surgical challenges associated with tailgut cysts is crucial for effective patient treatment.
• The presented cases highlight the need for individualized surgical planning based on cyst characteristics and patient anatomy to ensure optimal outcomes.