{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:04:30Z","timestamp":1792598670713,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Tailgut cysts often present asymptomatically or with nonspecific symptoms. While commonly benign, they may in rare cases be malignant, often transforming into adenocarcinoma. We present a 68-year-old female who presented with a sacral mass and abscess. Upon Emergency Department presentation, her inflammatory markers were elevated as well as her lactate. Initially, the patient was treated for possible infectious etiology with parenteral antibiotics. However, an MRI was obtained that showed concerns for myxoid neoplasm or chordoma. A biopsy was subsequently performed that revealed mucinous adenocarcinoma. Additionally, on imaging there was an enhancing pelvic lymph node concerning for metastatic spread. Tailgut cysts with malignant transformation to adenocarcinoma are rare and are typically treated surgically to obtain clear margins. However, neoadjuvant chemotherapy may be used in patients who have metastatic disease, which was pursued in the course of our patient\u2019s care. This case presentation emphasizes the importance of a wide differential for presacral masses with atypical presentations raising concerns for underlying malignancy. Prompt recognition and intervention is imperative in cases of malignant transformation of tailgut cysts.<\/jats:p>","DOI":"10.3389\/fonc.2025.1729627","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:30:18Z","timestamp":1767591018000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mucinous adenocarcinoma transformed from tailgut cyst: a case report and review of the literature"],"prefix":"10.3389","volume":"15","author":[{"given":"Qianyu","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Parker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andras","family":"Khoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Mohseni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2015.03.031","article-title":"Tailgut cyst: A case report and literature review","volume":"10","author":"Haydar","year":"2015","journal-title":"Int J Surg Case Rep"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.5858\/2000-124-0725-RCH","article-title":"Retrorectal cystic hamartoma: report of 5 cases with Malignancy arising in 2","volume":"124","author":"Prasad","year":"2000","journal-title":"Arch Pathol Lab Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e14546","DOI":"10.1111\/ijcp.14546","article-title":"Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review","volume":"75","author":"Mastoraki","year":"2021","journal-title":"Int J Clin Pract"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14628","article-title":"Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature","volume":"21","author":"Nicoll","year":"2019","journal-title":"Colorectal Dis"},{"key":"B5","article-title":"Unusual cause of defecation disturbance: a presacral tailgut cyst","volume":"17","author":"Akbulut","year":"2013","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.5.01841519","article-title":"Tailgut cyst: MRI evaluation","volume":"184","author":"Yang","year":"2005","journal-title":"AJR Am J Roentgenol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/BF02553440","article-title":"Retrorectal tumors. Mayo Clinic experience, 1960-1979","volume":"28","author":"Jao","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/89.2.139","article-title":"Tailgut cysts. Report of 53 cases","volume":"89","author":"Hjermstad","year":"1988","journal-title":"Am J Clin Pathol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16030","article-title":"Risk of Malignancy and outcomes of surgically resected presacral tailgut cysts: A current review of the Mayo Clinic experience","volume":"24","author":"Broccard","year":"2022","journal-title":"Colorectal Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1159\/000513028","article-title":"Retrorectal mucinous adenocarcinoma arising from a tailgut cyst: A case report","volume":"14","author":"Baverez","year":"2021","journal-title":"Case Rep Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.48.5722","article-title":"Wide local excision of perianal mucinous adenocarcinoma","volume":"33","author":"Ilbawi","year":"2015","journal-title":"J Clin Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"rjaa205","DOI":"10.1093\/jscr\/rjaa205","article-title":"Tailgut cyst: from differential diagnosis to surgical resection-case report and literature review","volume":"2020","author":"de Castro Gouveia","year":"2020","journal-title":"J Surg Case Rep"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2025.04.128","article-title":"Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis","volume":"20","author":"Al Jada","year":"2025","journal-title":"Radiol Case Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.5858\/2001-125-1361-PMIAAI","article-title":"p53 Mutation in adenocarcinoma arising in retrorectal cyst hamartoma (tailgut cyst): report of 2 cases\u2013an immunohistochemistry\/immunoperoxidase study","volume":"125","author":"Moreira","year":"2001","journal-title":"Arch Pathol Lab Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-226107","article-title":"Adenocarcinoma within a tailgut cyst","volume":"2018","author":"Costa","year":"2018","journal-title":"Br Med J Case Rep"},{"key":"B16","doi-asserted-by":"publisher","first-page":"38","DOI":"10.5604\/01.3001.0013.0810","article-title":"Tailgut cyst and a very rare case of a tailgut cyst with mucinous adenocarcinoma in a 73 year old woman treated for buttock abscess with fistula","volume":"91","author":"Rachel","year":"2019","journal-title":"Pol Przegl Chir"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i18.4200","article-title":"Mucinous adenocarcinoma of the buttock associated with hidradenitis: A case report","volume":"8","author":"Kim","year":"2020","journal-title":"World J Clin Cases"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.52.4.310","article-title":"Adenocarcinoma arising within a tailgut cyst: clinicopathological description and follow up of an unusual case","volume":"52","author":"Graadt van Roggen","year":"1999","journal-title":"J Clin pathology"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002253","article-title":"The Malignant transformation of retrorectal cystic hamartomas with blood irregular antibodies positive: A case report","volume":"94","author":"Zhao","year":"2015","journal-title":"Med (Baltimore)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v14.i9.1072","article-title":"Retrorectal mucinous adenocarcinoma arising from a tailgut cyst: A case report and review of literature","volume":"14","author":"Wang","year":"2022","journal-title":"World J Gastrointest Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.170.6.9609159","article-title":"Tailgut cyst with Malignancy: MR imaging findings","volume":"170","author":"Lim","year":"1998","journal-title":"AJR Am J Roentgenol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020941","article-title":"Tailgut cyst with adenocarcinoma transition: A rare case report","volume":"99","author":"Wang","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.4314\/gmj.v56i1.8","article-title":"Mucinous adenocarcinoma of a tailgut cyst","volume":"56","author":"Kumassah","year":"2022","journal-title":"Ghana Med J"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v13.i10.853","article-title":"Mucinous adenocarcinoma arising from a tailgut cyst: A case report","volume":"13","author":"Malliou","year":"2022","journal-title":"World J Clin Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbagrm.2008.08.003","article-title":"Interferon-sensitive response element (ISRE) is mainly responsible for IFN-alpha-induced upregulation of programmed death-1 (PD-1) in macrophages","volume":"1779","author":"Cho","year":"2008","journal-title":"Biochim Biophys Acta"},{"key":"B26","article-title":"Retrorectal cystic hamartoma associated with Malignant disease","volume":"51","author":"Jarboui","year":"2008","journal-title":"Can J Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.4322\/acr.2019.115","article-title":"Tailgut cyst adenocarcinoma","volume":"10","author":"Martins","year":"2020","journal-title":"Autops Case Rep"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-004-1178-y","article-title":"Adenocarcinoma arising in a tailgut cyst with prominent meningothelial proliferation and thyroid tissue: case report and review of the literature","volume":"446","author":"Andea","year":"2005","journal-title":"Virchows Arch"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1729627\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:30:19Z","timestamp":1767591019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1729627\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":28,"alternative-id":["10.3389\/fonc.2025.1729627"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1729627","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"article-number":"1729627"}}