Tailgut Cyst in a Neonate

Tailgut cysts are rare congenital lesions thought to arise from vestiges of the tailgut/postanal gut, which is a primitive gut temporarily present at the most caudal portion of the embryo. The lesions are usually multilocular cysts lined by various types of epithelium in the retrorectal space. We experienced a tailgut cyst in an 18-day-old girl initially presented as an epidermoid cyst like skin lesion in the coccygeal region. MRI showed a well-defined multiloculated cystic mass between the rectum and coccyx, measuring 12x23 mm and markedly hyperintense on T2 weighted images and hypointense on T1-weighted images. The cyst was surgically removed via a posterior sagittal approach and microscopically lined by ciliated columnar, transitional and squamous cells. Tailgut cysts are usually found in adult females, and extremely rarely in neonates. We report a tailgut cyst in a neonate with a review of the literature. (J Korean Surg Soc 2010;79:S67-70)