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Image of the Month—Diagnosis
Arch Surg. 2008;143(10):1018.
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Answer: Retrorectal Cystic Hamartoma (Tailgut Cyst)
Exploratory laparotomy and pelvic exploration with resection of the mass was performed. We approached the resection through a midline incision. Intraoperatively, we found a large, multicystic, fluid-filled mass that involved the superior rectal artery and significantly compressed the adjacent structures. The tumor was resected in continuity with the rectum and anus; a coccygectomy was also performed. No evidence was found of metastatic disease or lymphadenopathy.
Histologic examination of the specimen revealed a moderately differentiated adenocarcinoma with colorectal-type morphologic features arising within a tailgut cyst. The colorectal phenotype was confirmed immunohistochemically by positive stains for CDX2 and CK20 and a negative stain for CK7. Nine local lymph nodes were negative for malignant neoplasm. The surgical margins were free of malignant neoplasm. The patient elected to undergo adjuvant locoregional chemoradiotherapy, as recommended by our institutional tumor board.
A tailgut cyst, or retrorectal cystic hamartoma (RCH), is a rare congenital lesion that arises . . . [Full Text of this Article]
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Skye C. Mayo, Hahn Huang, Nora Dobos, and Kevin G. Billingsley
Arch Surg. 2008;143(10):1017.
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