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Re: Malignant transformation of tailgut cysts is significantly higher than previously reported: Systematic review of cases in the literature

We read with interest the article by Nicoll and colleagues(1), where an unusually high rate of malignant transformation of tailgut cysts is described (26.6% in a systematic review of 196 cases). The authors also advocate extended anterior resection for all cases on the basis that the mesorectum represents the embryonic mesentery and reference two case histories of recurrence in support of this. We consider this a dangerous overestimation of risk and dramatic overtreatment of a predominantly benign condition.