Carcinoid Tumor of the Sacrum: Case Report

Isolated intradural lumbosacral tailgut cyst with carcinoid features

Tailgut cysts are developmental cysts that arise from remnants of the embryonic postanal gut and are typically located within the presacral, retrorectal space. Isolated cases of aberrant locations, including prerectal, perirenal, perianal, retrovesical, and subcutaneous locations, have been reported. Malignant transformations with the presence of adenocarcinomas or carcinoids have been recognized within these entities. It is well recognized that anterior sacrococcygeal abnormalities are present and are frequently caused by the slow-growing nature of the tailgut cysts and related mass effect; however, the authors are aware of no reports in the literature of isolated tailgut cysts within the thecal sac in direct contact with neural elements, without extension into the peritoneal cavity. In this case, a 28-year-old woman presented with progressive back pain, frequent urinary tract infections, and bowel dysfunction. She was found to have a purely intradural tailgut cyst with malignant transformation consistent with carcinoid. No peritoneal extension of her disease was found. The authors hypothesize that this is a rare developmental aberration that has not been commonly recognized and potentially has implications for embryological development.

Neurological manifestation of sacral tumors

An extensive analysis of the existing literature concerning sacral tumors was conducted to characterize their clinical manifestations. Although certain specific manifestations can be attributed to some of the tumor types, a more general pattern of clinical presentation of an expansive sacral lesion can be elaborated. Local pain with or without pseudoradicular or radicular radiation is the most frequent initial symptom and is usually followed by the manifestation of a lumbosacral sensorimotor deficit; bladder/bowel and/or sexual dysfunction appear throughout the natural course of disease.

Isolated carcinoid tumor of the terminal filum. Case report

The authors describe a patient with neurological symptoms caused by a carcinoid tumor at the terminal filum without carcinoid "flushing" syndrome or endocrinological abnormalities. The patient underwent subtotal resection and adjuvant radiotherapy. Extensive postoperative workup revealed no primary site of disease. To the authors' knowledge, this patient represents the first case of terminal filum carcinoid tumor.