Case report reveals rare malignant transformation of a tailgut cyst to mucinous adenocarcinoma, indicating need for thorough follow-up.
A tailgut cyst is an embryological remnant of the posterior intestine and is usually benign in nature. Malignant transformation is very rarely seen. We report a case of a tailgut cyst transforming into a mucinous adenocarcinoma. An 18-year-old gentleman presented to our healthcare center with progressive pain and heaviness in the lower abdomen and lower back for 1 year. Contrast-enhanced computed tomography reveals a cystic mass in the presacral region. The patient underwent transabdominal excision of the cyst in toto, and histopathological evaluation revealed mucinous adenocarcinoma. The patient underwent adjuvant chemo-radiotherapy, and after one year, contrast-enhanced computed tomography revealed no residual or recurrence. Tailgut cysts carry the risk of fecal incontinence, fecal fistula, neurogenic bladder, and malignant transformation. Hence, complete excision followed by adjuvant treatment is advised. Excision can be done by transabdominal, posterior (Presacral/ Pre-coccygeal), or combined approach.
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Kumar et al. (2025) studied this question.
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