EP31.23: Tailgut cyst mistaken for endometriosis: a case report

Tailgut cysts (cystic hamartomas), are congenital lesions that arise from vestiges of the embryological hindgut. They usually occur in the retro-rectal (presacral) space. The differential diagnosis of these masses can be congenital, inflammatory, embryological, neurogenic, or osseous. Tailgut cysts lesions are rare and can present a challenge both in diagnosis and management. They can present at any age, although usually between the ages of 30 and 60. The female to male ratio is 5:1. 24 cases of malignancy of Tailgut cyst have been reported in the literature. We present the case of a 44-year-old female with an incidental finding of a Tailgut cyst. The patient was in surveillance of the Gynecologic Clinic, at the Kapan Medical Center due to abdominal pain and suspected Endometriosis. She was known to have a uterus with fibrous myomas, adenomyosis and a small right dermoid cyst. In a gynecologic ultrasound examination, in the retroperitoneum, in the midline, above the rectum, a cystic finding with delicate partitions, with 38X30X35 mm dimensions and clear fluid within the cyst, with a negative colour Doppler flow, was presented. CT and MRI scans confirmed the suspicion of a Tailgut cyst. In conclusion, the rare retro-peritoneal pelvic findings in a gynecologic ultrasound examination are mostly incidental. A correct diagnosis is essential due to the risk of malignancy in some cases and in order to prevent unnecessary or incorrect interventions which could pose iatrogenic morbidity. Due to the risk of malignancy, surgical excision is to be recommended to the patient. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.