Coccygeal Dermal Sinus Associated with Presacral Tailgut-Type Cysts in Children: A Case Series

A bstract Congenital coccygeal dermal sinus is a form of closed spinal dysraphism that carries a risk of infection and deeper anatomical extension. Presacral developmental cysts, including tailgut-type cysts, are uncommon in the pediatric population and may coexist with dermal sinus tracts, posing diagnostic and surgical challenges. We present a pediatric case series of two female children with coccygeal dermal sinus associated with presacral cystic lesions. In both cases, preoperative magnetic resonance imaging (MRI) accurately delineated the dermal sinus tract, excluded the intradural extension, and identified the associated presacral pathology, thereby facilitating appropriate surgical planning. Surgical excision was performed in both patients, with coccygectomy required in one case. Histopathological evaluation confirmed tailgut-type presacral cysts with epithelial heterogeneity. One patient experienced recurrence, necessitating re-excision, while the other had an uncomplicated postoperative course. This case series underscores the importance of careful MRI evaluation of the sacrococcygeal and presacral regions in children presenting with coccygeal dermal sinus to ensure comprehensive diagnosis and optimal management.