Coccygectomy without Soft Tissue Reduction for the Treatment of Coccygeal Pad

A 15-year-old male patient was referred to our hospital with a congenital elevated lesion in the sacrococcygeal region, which measured 8 × 5 cm. Six months prior to presentation, the patient developed redness and pain in the lesion during cycling. Computed tomography revealed dorsal angulation of the 5th sacral segment (S5) and the 1st coccygeal segment (Cy1) and ventral angulation of Cy2 to 4th coccygeal segment (Cy4). Under general anesthesia, Cy1 to Cy4 were resected and S5 was flattened. Soft tissue and overlying tissue of the coccyx were not resected. At the 18-month follow-up, the patient exhibited no recurrence of the coccygeal pad (CCP) or associated pain. Pathologically, CCP consists of connective tissue. However, the coccyx deformity can cause subjective symptoms. This case suggests that coccygectomy without skin or soft tissue resection can be an effective treatment for CCP.