Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis

Tailgut cysts (TGCs) are rare congenital lesions arising from incomplete regression of the embryonic hindgut, typically located in the presacral space and more common in females. Although often benign, these cysts carry a risk of malignant transformation. We report a case of a woman in her early 50s...

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Main Authors: Iyad Al Jada, MD, PhD, Majd Oweidat, MD, Mohammad Khaleel, MD, Omar Harb, MD, Ursula Abu Nahla, MD, Rahaf Bleibel, MD, Mai Arafeh, MD, Ammar W.M. Hassouneh, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325004224
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author Iyad Al Jada, MD, PhD
Majd Oweidat, MD
Mohammad Khaleel, MD
Omar Harb, MD
Ursula Abu Nahla, MD
Rahaf Bleibel, MD
Mai Arafeh, MD
Ammar W.M. Hassouneh, MD
author_facet Iyad Al Jada, MD, PhD
Majd Oweidat, MD
Mohammad Khaleel, MD
Omar Harb, MD
Ursula Abu Nahla, MD
Rahaf Bleibel, MD
Mai Arafeh, MD
Ammar W.M. Hassouneh, MD
author_sort Iyad Al Jada, MD, PhD
collection DOAJ
description Tailgut cysts (TGCs) are rare congenital lesions arising from incomplete regression of the embryonic hindgut, typically located in the presacral space and more common in females. Although often benign, these cysts carry a risk of malignant transformation. We report a case of a woman in her early 50s who presented with abdominal pain, urinary retention, and tenesmus. Initial imaging revealed a large presacral cystic lesion, and incomplete surgical excision confirmed benign histology. However, the patient returned 6 months later with recurrent symptoms and new-onset lower limb weakness. Repeat imaging showed a recurrent cystic lesion with liver and bony metastases. MRI showed peripheral nodular enhancement of the lesion and enhancing bone lesions. A liver biopsy confirmed mucinous adenocarcinoma. Despite chemotherapy, the disease progressed rapidly, and the patient passed away within 2 months. This case highlights the potential for malignant degeneration in TGCs, which, though rare, carries significant morbidity. Complete surgical resection and follow-up are critical to prevent recurrence and malignancy risk. Further research is needed to study the malignant transformation predictors of this rare entity.
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publishDate 2025-08-01
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series Radiology Case Reports
spelling doaj-art-8f6d34d6ff1e4fab96a0b06ab9545ec92025-08-20T03:26:38ZengElsevierRadiology Case Reports1930-04332025-08-012084022402710.1016/j.radcr.2025.04.128Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasisIyad Al Jada, MD, PhD0Majd Oweidat, MD1Mohammad Khaleel, MD2Omar Harb, MD3Ursula Abu Nahla, MD4Rahaf Bleibel, MD5Mai Arafeh, MD6Ammar W.M. Hassouneh, MD7College of Medicine, Hebron University, Hebron, West Bank, Palestine; Department of Surgery, Princess Alia Hebron Governmental Hospital, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, Palestine; Corresponding author.College of Medicine, Hebron University, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, PalestineCollege of Medicine, Hebron University, Hebron, West Bank, Palestine; Department of Radiology, Princess Alia Hebron Governmental Hospital, Hebron, West Bank, PalestineTailgut cysts (TGCs) are rare congenital lesions arising from incomplete regression of the embryonic hindgut, typically located in the presacral space and more common in females. Although often benign, these cysts carry a risk of malignant transformation. We report a case of a woman in her early 50s who presented with abdominal pain, urinary retention, and tenesmus. Initial imaging revealed a large presacral cystic lesion, and incomplete surgical excision confirmed benign histology. However, the patient returned 6 months later with recurrent symptoms and new-onset lower limb weakness. Repeat imaging showed a recurrent cystic lesion with liver and bony metastases. MRI showed peripheral nodular enhancement of the lesion and enhancing bone lesions. A liver biopsy confirmed mucinous adenocarcinoma. Despite chemotherapy, the disease progressed rapidly, and the patient passed away within 2 months. This case highlights the potential for malignant degeneration in TGCs, which, though rare, carries significant morbidity. Complete surgical resection and follow-up are critical to prevent recurrence and malignancy risk. Further research is needed to study the malignant transformation predictors of this rare entity.http://www.sciencedirect.com/science/article/pii/S1930043325004224Tailgut cystMetastasisMucinous adenocarcinomaMalignant degeneration
spellingShingle Iyad Al Jada, MD, PhD
Majd Oweidat, MD
Mohammad Khaleel, MD
Omar Harb, MD
Ursula Abu Nahla, MD
Rahaf Bleibel, MD
Mai Arafeh, MD
Ammar W.M. Hassouneh, MD
Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
Radiology Case Reports
Tailgut cyst
Metastasis
Mucinous adenocarcinoma
Malignant degeneration
title Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
title_full Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
title_fullStr Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
title_full_unstemmed Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
title_short Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
title_sort recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
topic Tailgut cyst
Metastasis
Mucinous adenocarcinoma
Malignant degeneration
url http://www.sciencedirect.com/science/article/pii/S1930043325004224
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