True tail in a neonate
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《美国医学杂志》
Department of Pediatric Surgery, LTM Medical College and General Hospital, Sion, Mumbai, India
Abstract
Distinction between true and pseudo trail in lumbo-sacral region is important since treatment and prognosis are different. Fewer than 40 cases have been reported in literature. The authors report a case of true tail in a neonate, a rare event.
Keywords: Human tails; Neonate
Human tail is a rare congenital anomaly. Dao and Netsky classified human tails into true and pseudo tails. True tails are remnants of embryologic tail whereas all other lumbosacrococcygeal protrusions are leveled as peudo tails.
Case report
A full term 20-day-old male presented with proper soft tissue mass in lower back Figure1. It appeared like a tail in a neonate. Maternal history showed no drug exposure during pregnancy and diabetes mellitus.
General and systemic examination was normal. Local examination of sarco-coccygeal region revealed a single tail raising from the right side of midline. It had a bulbous ending with lanugo hair. It was 6''×'' long well covered by skin and had no movements. Neurological history and examination were normal. X-ray lumbo-sacral spine was normal.
Extension of tail confirmed presence of mesenchymal tissue (adipose, connective, nerve, striated muscle, blood vessels and cutis). Postoperative course was on eventful.
Discussion
Human tail a rare congenital anomaly is classified into true and pseudo tails by Dao and Netsky.[1] True tails contain only mesenchymal tissue and pseudo tails contain lipoma, teratoma, cartilage, glioma, parasitic feutus and meningomyclocele. The tail is situated in the sarco-occygeal region and can be located 1.5 cm to either side. It occurs twice in males as in females.[2]
Caudal appendages are associated with other congenital anomalies in 29% of cases, spida bifida being the most frequent anomaly.[3] Other anomalies reported are cleft palate, congenital heart disease, vagina atresia, horseshoe kidney etc.[4] Our patient was spared from having midline anomaly.
Microscopic examination has shown an associated lipoma, lipomeningocele, wel-developed neurons, glial fibers classifications and capillary hemangioma.[2],[5] It is important to distinguish between true and pseudo tail since the treatment and prognosis are different. Preoperative assessment must include a complete neurological history and examination.
References
1. Dao AH, Netsky MG. Human tails and pseudo tails. Hum Parsons 1984; 15(5): 449-453
2. Parson RW. Human tails. Plast Reconst Surg 1960; 25: 618-621
3. Durbow TJ, Wackyn PA, Leasaboy MA. Detailing the human tail. Ann Plast Surg 1988; 20: 340-344.
4. Alashari M, Torakawa J. True tail in a newborn. Pediatr Dermat 1995; 12(3): 263-266.
5. Belzberg AJ, Myles ST, Trevenen CL. The human tail and spinal dysraphism. J Pediatr Surg 1991; 26(10): 1243-1245.(Kothari Paras R, Gupta Ar)
Abstract
Distinction between true and pseudo trail in lumbo-sacral region is important since treatment and prognosis are different. Fewer than 40 cases have been reported in literature. The authors report a case of true tail in a neonate, a rare event.
Keywords: Human tails; Neonate
Human tail is a rare congenital anomaly. Dao and Netsky classified human tails into true and pseudo tails. True tails are remnants of embryologic tail whereas all other lumbosacrococcygeal protrusions are leveled as peudo tails.
Case report
A full term 20-day-old male presented with proper soft tissue mass in lower back Figure1. It appeared like a tail in a neonate. Maternal history showed no drug exposure during pregnancy and diabetes mellitus.
General and systemic examination was normal. Local examination of sarco-coccygeal region revealed a single tail raising from the right side of midline. It had a bulbous ending with lanugo hair. It was 6''×'' long well covered by skin and had no movements. Neurological history and examination were normal. X-ray lumbo-sacral spine was normal.
Extension of tail confirmed presence of mesenchymal tissue (adipose, connective, nerve, striated muscle, blood vessels and cutis). Postoperative course was on eventful.
Discussion
Human tail a rare congenital anomaly is classified into true and pseudo tails by Dao and Netsky.[1] True tails contain only mesenchymal tissue and pseudo tails contain lipoma, teratoma, cartilage, glioma, parasitic feutus and meningomyclocele. The tail is situated in the sarco-occygeal region and can be located 1.5 cm to either side. It occurs twice in males as in females.[2]
Caudal appendages are associated with other congenital anomalies in 29% of cases, spida bifida being the most frequent anomaly.[3] Other anomalies reported are cleft palate, congenital heart disease, vagina atresia, horseshoe kidney etc.[4] Our patient was spared from having midline anomaly.
Microscopic examination has shown an associated lipoma, lipomeningocele, wel-developed neurons, glial fibers classifications and capillary hemangioma.[2],[5] It is important to distinguish between true and pseudo tail since the treatment and prognosis are different. Preoperative assessment must include a complete neurological history and examination.
References
1. Dao AH, Netsky MG. Human tails and pseudo tails. Hum Parsons 1984; 15(5): 449-453
2. Parson RW. Human tails. Plast Reconst Surg 1960; 25: 618-621
3. Durbow TJ, Wackyn PA, Leasaboy MA. Detailing the human tail. Ann Plast Surg 1988; 20: 340-344.
4. Alashari M, Torakawa J. True tail in a newborn. Pediatr Dermat 1995; 12(3): 263-266.
5. Belzberg AJ, Myles ST, Trevenen CL. The human tail and spinal dysraphism. J Pediatr Surg 1991; 26(10): 1243-1245.(Kothari Paras R, Gupta Ar)