Adenocarcinoma within a tailgut cyst

Description 

We present a case of a 53-year-old woman with painful defaecation and lower abdominal pain. Her medical history and laboratory testing were unremarkable. An abdominopelvic CT scan was performed. Axial non-enhanced CT image (figure 1) and postcontrast CT image (figure 2) revealed a well-defined, slightly lobular soft tissue density mass in the retrorectal/presacral space. It shows a thin peripheral calcification and internal enhancing components after administration of intravenous contrast material. These features suggest a rare developmental retrorectal lesion, with enteric cysts (tailgut cyst and cystic rectal duplication) being the more common. Differential diagnosis comprises lymphangioma, epidermoid cyst, dermoid cyst, endometrioma, rectal duplication cyst, anal gland cyst and anterior meningocoele.

Figure 1

Axial non-enhanced CT image showing a heterogeneous nodular mass of tissue density with a tiny peripheral calcification in the presacral space.

Figure 2

Axial and sagittal postcontrast...

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