Human Tail with Noncontiguous Intraspinal Lipoma and Spinal Cord Tethering:Case Report and Embryologic Discussion

Children born with a tail-like appendage have a rare malformation that is frequently associated with abnormalities of the spine and spinal cord. A contiguous fibrolipoma is usually seen extending from the subcutaneous portion of the tail into the inferior spinal cord, resulting in tethered cord syndrome. We present the case of a child born with a tail and intraspinal lipoma that were not contiguous with each other, and were separated by an intact layer of lumbosacral fascia. The tail and lipoma were removed and the spinal cord untethered, and the child is neurologically normal 2 years after surgery. The absence of a contiguous lipoma from the tail to the spinal cord suggests that this condition may be principally caused by a disorder of secondary neurulation and/or regression of the normal embryonic tail bud. The embryology of the lower spine is reviewed and possible etiologies discussed.

[1]  M. England,et al.  Morphological diversity of dying cells during regression of the human tail. , 2001, Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft.

[2]  E. Gönül,et al.  The human tail associated with intraspinal lipoma: case report. , 2000, Minimally invasive neurosurgery : MIN.

[3]  T. Canty,et al.  Human Tails and Associated Spinal Anomalies , 1995, Clinical pediatrics.

[4]  A. Baruchin.  Human tail. , 1995, British journal of plastic surgery.

[5]  E. Lehtonen,et al.  Morphological and immunohistochemical characteristics of axial structures in the transitory human tail. , 1994, Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft.

[6]  T. Yamamoto,et al.  Human tail associated with lipomeningocele--case report. , 1994, Neurologia medico-chirurgica.

[7]  R. Nievelstein,et al.  Embryonic development of the mammalian caudal neural tube. , 1993, Teratology.

[8]  N. Tamaki,et al.  Myelomeningocele and thick filum terminale with tethered cord appearing as a human tail. Case report. , 1993, Journal of neurosurgery.

[9]  S. J. Gaskill,et al.  Neuroectodermal appendages: the human tail explained. , 1989, Pediatric neuroscience.

[10]  M. Lesavoy,et al.  Detailing the human tail. , 1988, Annals of plastic surgery.

[11]  R. Spiegelmann,et al.  The human tail: a benign stigma. Case report. , 1985, Journal of neurosurgery.

[12]  E. Hendrick,et al.  Management of lipomyelomeningoceles. Experience at the Hospital for Sick Children, Toronto. , 1985, Journal of neurosurgery.

[13]  M. Netsky,et al.  Human tails and pseudotails. , 1984, Human pathology.

[14]  L. Sutton,et al.  The management of the child with a lipomyelomeningocele. , 1983, Clinical neurosurgery.

[15]  F. Ledley.  Evolution and the human tail: a case report. , 1982, The New England journal of medicine.

[16]  Y. Ohhara.  Human Tail and Other Abnormalities of the Lumbosacrococcygeal Region Relating to Tethered Cord Syndrome , 1980, Annals of plastic surgery.

[17]  G. W. Hambrick,et al.  Cutaneous signs of spinal dysraphism. Report of a patient with a tail-like lipoma and review of 200 cases in the literature. , 1978, Archives of dermatology.

[18]  G. D. Lundberg,et al.  A case of a human tail. , 1962, American journal of diseases of children.