Presacral tailgut cyst in a 5-year-old girl: a case report

: Introduction Tailgut cysts are rare congenital presacral lesions resulting from incomplete regression of the embryonic tailgut. They are uncommonly diagnosed in children and may be difficult to distinguish from other presacral masses. Case presentation A 5-year-old girl underwent pelvic ultrasonography as part of the evaluation of premature thelarche. The examination incidentally revealed a pre-sacral mass, although the patient had no symptoms related to the lesion. CT and pelvic MRI demonstrated a 42–43 mm presacral cystic lesion at the S3–S4 level, displacing the rectum anteriorly without luminal communication and suggesting a tailgut cyst. Tumor markers were negative. Laparoscopic exploration did not provide safe access to the retrorectal space; therefore, the procedure was converted to a posterior approach with coccygectomy. Complete excision was achieved without cyst rupture. Histopathological examination showed a cyst lined by stratified squamous, ciliated columnar, and transitional epithelium, confirming the diagnosis of a tailgut cyst. The postoperative course was uneventful, and the patient remained asymptomatic at 3-month follow-up. Conclusion Tailgut cyst must be included in the differential diagnosis of presacral masses in children. The posterior approach seems to be an efficient way to accomplish complete resection.