Kocaeli Med J. 2017; 6(3): 85-87

CT Imaging Characteristics of Neuroendocrine Tumor Arising From Tailgut Cyst: Case Report

Nevin Aydýn¹, Taylan Kara², Mahmut Kebapçý³, Deniz Arýk⁴, Sare Kabukçuoðlu^4
1Dumlupýnar University Evliya Celebi Education And Research Hospital, Department Of Radiology, Kutahya, Turkey
²Mersin University Medical Faculty Department Of Radiology, Mersin, Turkey
³Eskisehir Osmangazi Universiry Medical Faculty Department Of Radiology, Eskisehir, Turkey
⁴Eskisehir Osmangazi Universiry Medical Faculty Department of Pathology, Eskisehir, Turkey

The tailgut is the most caudal part of the hindgut, it forms the distal part of the anus. It normally involutes by the eighth week of gestational age. If a tailgut rest proceeds, it may give rise to a tailgut cyst. Malign transformation of the tailgut cyst is very rare. Adenocarcinoma, neuroendocrine carcinoma, and sarcoma developing within the tailgut cyst has been reported in the literature. We present a case of neuroendocrin tumor which is arised from a tailgut cyst in a middle aged woman with its computed tomography (CT) imaging findings. A 35 year-old woman with a history of endometriosis admitted to our hospital with abdominal pain. An ultrasonography (US) examination and contrast medium enhanced tomography of the abdomen and pelvis was performed. CT showed multiple well-defined solid heterojen masses in presacral space.The largest dimensions of the masses were 6.5x6x6.5 cm. The patient underwent surgery. Patology was reported as neuroendocrin tumor arising within tailgut cyst. It is usually detected as an asymptomatic mass in the presacral space between rectum and sacrum. Tailgut cyst is more common in female and usually presents in middle age(mean 35), but it can present at any age. Our patient was female and 35 years old. Discrimination of tailgut cyst from other presacral cysts is important because of the malignant potential of a tailgut cyst. Malign transformation is very rare. Adenocarcinoma, neuroendocrine carcinoma, and sarcoma developing within the tailgut cyst has been reported. In our case patology was reported as neuroendocrin tumor arising within tailgut cyst. It should be kept in mind the differential diagnosis of presacral masses because of the malignant potential of a tailgut cyst.

Keywords: Tailgut cyst, neuroendocrine tumor, presacral space

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Tailgut Kisti Zemininde Geliþen Nöroendokrin Tümörün BT Bulgularý

Nevin Aydýn¹, Taylan Kara², Mahmut Kebapçý³, Deniz Arýk⁴, Sare Kabukçuoðlu^4
1Dumlupýnar Üniversitesi Evliya Çelebi EAH Radyoloji Bölümü, Kütahya, Türkiye
²Mersin Üniversitesi Týp Fakültesi Radyoloji AD, Mersin, Türkiye
³Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Radyoloji AD, Eskiþehir, Türkiye
⁴Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Patoloji AD, Eskiþehir, Türkiye

Tailgut (postnatal gut), hintgutun en kaudal parçasý olup anüsün gelecekteki distal kesimini oluþturur. Genelde embriyonik hayatýn 8. haftasýnda involüsyona uðrar. Tailgut kisti involüsyona uðramayan kalýntýlardan köken alýr. Tailgut kistinden malignensi geliþimi çok nadir olup en sýk adenokarsinom, nöroendokrin tümör ve sarkom geliþimi bildirilmiþtir. Biz burada tailgut kisti zemininde geliþen nöroendokrin tümörün bilgisayarlý tomografi (BT) bulgularýný sunmayý amaçladýk. Otuzbeþ yaþýnda endometriozis nedeniyle takipte olan kadýn hasta, karýn aðrýsý þikayeti ile baþvurdu. Hastaya ultrasonografi (US) ve kontrastlý abdominopelvik BT çekildi. BT’de presakral alanda büyüðü yaklaþýk 6.5x6x6.5 cm çapta solid heterojen düzgün sýnýrlý multiple nodüler kitleler mevcuttu. Hastaya yapýlan cerrahi operasyon sonrasýnda patoloji sonucu tailgut kisti zemininde geliþen nöroendokrin tümör olarak raporlandý. Tailgut kisti asemptomatiktir,en sýk presakral bölgede rektum ile sakrum arasýnda izlenir. Kadýnlarda daha sýk rastlanýr. Her yaþ grubunda görülebilse de orta yaþ grubunda (ortalama 35 yaþ) daha sýk taný alýr. Bizim hastamýz da kadýn ve 35 yaþýndaydý. Tailgut kisti ile diðer presakral kistik lezyonlarýn ayýrýcý tanýsý tailgut kistinin malign transformasyonu nedeniyle yapýlmalýdýr. Tailgut kisti nadiren malign transformasyon göstermekte olup; adenokarsinom,nöroendokrin tümör ve sarkom geliþimi bildirilmiþtir. Hastamýzda lezyonlarýn eksizyonu sonucu patoloji nöroendokrin tümör olarak gelmiþtir. Presakral bölgede saptanan kitlelerde tailgut kisti malignite potansiyeli nedeniyle ayýrýcý tanýda akýlda bulundurulmalýdýr.

Anahtar Kelimeler: Tailgut kisti, nöroendokrin tümör, presakral alan

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