Heterotopic glial nodule is a rare congenital non-neoplastic lesion that is characterized by ectopic brain tissue. It has occasionally been reported to affect areas such as the nose and face. The report presents a rare case of sacrococcygeal heterotopic glial nodule. Although teratomas are the most common neoplasms in this region, clinicians and radiologists should consider heterotopic glial nodule as a differential diagnosis, despite rarity and nonspecific imaging findings. Histopathology plays a crucial role in diagnosis, which intensely stains with glial fibrillary acidic protein and S-100.

Germ cell tumors (GCT) are a complex, heterogeneous collection of tumors that may present in either gonadal or extragonadal sites. They consist of a variety of benign and malignant histologies that can occur at several locations throughout the body. An important component of treatment is surgical resection, and while the key components of resection are site specific, the universal goals of GCT resection include the complete resection of tumor without violating the tumor capsule, while preserving function of surrounding organs, minimizing morbidity, and assessing for regional spread.

Sacrococcygeal teratoma (SCT) in adults is very rare with only a few cases documented in the literature, adult prevalence varies between 1 in 40 000 and 1 in 63 000. Most SCTs are located either mainly extra-pelvic (types I and II), which are more commonly seen in neonates; however, mainly intra-pelvic tumors (types III and IV) are more typical in adulthood. Extra-pelvic teratomas are extremely rare in adults. When SCT manifests in an adult, it appears as a slow-growing tumor without symptoms and usually manifests after becoming large enough to cause compression symptoms. SCT has a 1-2% probability of malignant transformation. Herein, we report a 20-year-old female, who was diagnosed with lower back swelling since childhood that increased in size over the last 2 months; imaging revealed an extra-pelvic mass. This case describes an atypical scenario for SCT, which was successfully managed with surgery. The histopathology report confirmed the diagnosis.

A rare extragonadal mixed germ cell tumor of the sacrococcygeal area presenting with mature thymic tissue in the teratomatous component, a rare finding and the first reported case of such an association.

Sacrococcygeal teratoma (SCT), one of the most common neoplastic tumors in newborns, is found very rarely in adults. These teratomas are germ cell tumours. Most of these tumors are benign and cystic in nature, with only 1-2% of them having a malignant transformation. Most of these tumors are benign and cystic in nature, with only 1-2% of them having malignant transformation. A higher incidence was seen in females. Typically, cystic teratomas are asymptomatic, and so the diagnosis was often made inadvertently during radiographic studies. The majority of treatment is complete surgical excision, and both open and laparoscopic procedures have been proven to be efficient. Histopathologic examination can confirm the diagnosis. We present this unusual instance of a 56-year-old female patient with a sacrococcygeal teratoma.

Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, n = 30) or a sacrococcygeal (SC, n = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann-Whitney U test, Student\'s t-test or Fisher\'s Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at -10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC (p = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.

We describe the unusual case of a female patient with a history of two mature teratomas non-correlated in terms of location and occurrence. A 12-year-old girl presented at our consultation as a result of a growing tumor in the hypogastric region, with no further clinical signs. She had undergone surgery neonatally due to a mature cystic sacrococcygeal teratoma, which was fully removed. No clinical sequelae were noted and no additional treatment was required over a 10-year follow-up. Radiological examination showed a large 20 × 12 × 18 cm cystic mass extending from the pelvic region to the lower hemiabdomen, associated with two similar small formations adjacent to the right ovary. Tumor markers were negative, and a laparoscopic right salpingoophorectomy was carried out, with an excellent postoperative progression. Pathological examination revealed it was, again, a mature cystic teratoma. The genetic study ruled out causation in this respect.
Describimos el inusual caso de una paciente con antecedente de dos teratomas maduros no relacionados en cuanto a su localización y debut. Una niña de 12 años consultó por la aparición de una tumoración en la región hipogástrica de crecimiento progresivo sin otra clínica asociada. Había sido intervenida por un teratoma quístico maduro sacrococcígeo en el periodo neonatal con su extirpación completa y, ausencia secuelas clínicas y tratamiento adicional durante diez años de seguimiento posterior. Los exámenes radiológicos mostraron una gran masa quística de 20 × 12 × 18 cm que se extendía entre la región pélvica y el hemiabdomen inferior, acompañada por otras dos pequeñas formaciones similares adyacentes al ovario derecho. Los marcadores tumorales resultaron negativos y se llevó a cabo una salpingooforectomía derecha laparoscópica con una excelente evolución postoperatoria. El examen histopatológico, de nuevo, informó la lesión como teratoma quístico maduro. El estudio genético descartó una posible causalidad en este ámbito.

We present a case of a bronchogenic cyst in the retrorectal space that was successfully treated with a unique sacrococcygeal surgical approach, thus avoiding abdominal access. This report aims to enhance the literature with our technique and to help the scientific community in treating future retrorectal bronchogenic cyst cases. A 19-year-old man presented to the hospital with testicular pain refractory to over-the-counter analgesics. A cyst lesion in the presacral region was found during pelvic magnetic resonance imaging. We identified the cyst\'s epithelium as the respiratory type, containing ciliated pseudostratified columnar epithelium with foci of squamous metaplasia. The bronchogenic cyst is abnormal from the primitive foregut, and its location on the retrorectal site is rare. Patients with this type of lesion are usually asymptomatic, and discovery is commonly incidental during imaging exams. Excision is advised, and the prognosis is good after retroperitoneal bronchogenic cyst removal. Our description of the topic is essential to assist future similar cases.

Sacrococcygeal yolk sac tumor (YST) is an infrequent extra-gonadal malignant germ cell tumor (GCT) that occurs exclusively within the first two years of life. A two-year-old girl came with a massive mass on her left buttock, which continued to grow, and within three months had become extremely large and hindered her from walking. Physical examination revealed a sacrococcygeal mass of 15 cm in diameter. Multislice CT showed an intraluminal inferior cava vein mass extending into the pelvic cavity with coccygeal osseous destruction, pulmonary metastasis, and multiple hepatic metastases. Laboratory data revealed elevated tumor marker values for alpha-feto-protein (AFP), lactate dehydrogenase (LDH), and Ca-125. Cytopathology following fine needle aspiration biopsy evaluation of the smear sample revealed a cellular tumor with pseudo glandular, microcystic, and solid patterns. The cytopathology did not show pathognomic findings. An immunocytochemistry (IHC) examination of the cell block showed a positive result for anti-AFP antibody. The patient was diagnosed and treated with chemotherapy for a sacrococcygeal YST. Clinical follow-up on the fourth month showed that the tumor had shrunk to 4 cm in size. Laboratory follow-up data after four months showed significant improvement. Unfortunately, the patient passed away on the seventh cycle of chemotherapy due to lung and hepatic metastases.

Pilonidal disease (PD) is a common and debilitating inflammatory condition with significant impact on quality of life. Minimally invasive techniques (MIT) have shown promising results comparing to traditional excision. Herein we present a comparison of two MIT techniques -sinusectomy (SE) and pit-picking plus laser ablation (PPL).
All cases of paediatric PD treated by PPL and SE at our center between August 2018 and August 2020 were retrospectively reviewed.
One-hundred and six patients were included, with a median age of 16 years (IQR 15-16). PPL was the procedure of choice in 36 patients (34%) and the remaining underwent SE (66%). Median healing time was significantly lower in SE group (20 days), comparing to PPL (30 days) (p = 0.002). Early healing failure occurred more frequently in the PPL group (p = 0.003). Recurrence rate was similar between groups - PPL 17% versus SE 16% (p = 0.89). Overall complication rate was 9% and was significantly higher in PPL (p = 0.03).
MIT techniques are promising solutions in PD treatment. Although similarly easy and fast to perform, SE technique showed better healing profile and lower complication rate but no significant difference on recurrence rates was observed.