Infant With a "Tail"

A 6-cm midline tail-like soft tissue appendage was noted on the back of this newborn infant at the level of L5. An epithelialized mid-sacrum dimple was also present inferior to the appendage. The infant otherwise appeared to be normally developed.

According to Dorothea Verbrugge, MD, and William Peugh, MD, of American Fork, Utah, roentgenograms and ultrasonograms of the appendage and dimple region showed no evidence of neurologic or bony tissue in either structure. Thus, the tail was surgically removed when the infant was 6 weeks old. Pathology reports confirmed a core of adipose tissue and smooth muscle with overlying squamous epidermis; there was no evidence of neurologic or malignant tissue.

A review of the literature suggests that a tail-like structure can indicate an increased risk of spinal dysraphism, tethered cord, or intraspinal lipoma.^1-3 MRI was ordered for this infant; it showed a tethered cord without evidence of a lipoma or other spinal defects.

The patient was referred to neurosurgery for an untethering procedure, which was completed when the child reached 5 months of age. The infant has continued to develop normally.

REFERENCES:1. Lu FL, Wang PJ, Teng RJ, Yau KI. The human tail. Pediatr Neurol. 1998;19:230-233.
2. Gonul E, Izci Y, Onguru O, et al. The human tail associated with intraspinal lipoma: a case report. Minim Invasive Neurosurg. 2000;43:215-218.
3. Belzberg AJ, Myles ST, Trevenen CL. The human tail and spinal dysraphism. J Pediatr Surg. 1991;26:1243-1245.