Presentation
MRI was done for assessment of pelvic cysts, suspected as ovarian cysts.
Patient Data
A bilocular cyst is noted in the pre-sacral retro-rectal concavity, separable from both ovaries. It measures 10 x 9 x 8.5 cm in its maximal AP, side to side, and cephalocaudal dimensions respectively. It shows a homogeneous fluid signal with no solid components and internal septation.
The cyst exerts mass effect upon adjacent pelvic structures. It compresses and displaces the rectum to the right side, the uterus, vagina, and the urinary bladder anteriorly and superiorly.
Multilocular left ovarian cyst is noted, measuring 6.5 cm, with no suspicious features (functional cyst).
Case Discussion
The diagnosis of the tailgut duplication cyst was based on the classic features of fluid-filled cyst found in the retrorectal/ presacral space with internal septation which is characteristic. It can be asymptomatic or present with perirectal symptoms.
Differential diagnosis includes epidermoid cyst, dermoid cyst, rectal duplication cyst, anal gland cyst, cystic lymphangioma, and anterior meningocele. The distinction of tailgut cyst from other presacral cysts is important because of the malignant potential of the tailgut cyst.
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