Introduction: The dorsal cutaneous appendage or the so-called human tail, is a rare congenital anomaly. The spectrum of pathology includes isolated skin and subcutaneous tissue appendages with potential of underlying spinal dysraphism and tethered cord.
Methods: We present a series of three patients, two pediatric and one adult, that reflect the wide spectrum of phenotypes with varying degrees of associated spinal anomalies.
Results: A one year old female with a large tail had spinal dysraphism in continuity with a lipomyelocele. The patient developed symptoms of progressive left lower extremity weakness and foot drop over the first year-of-life. A 10 months old female with a smaller tail isolated to the skin and subcutaneous tissue associated with a dorsal intradural lipoma and presented with frequent urinary tract infections (UTI). Both patients, underwent microsurgical detethering and cosmetic repair of the respective skin appendages. The neurological symptoms resolved in both patients at two year follow/up and parents were also satisfied with the cosmetic result. The third patient, a 22 year female, presented with a small tail isolated to the skin in the sacral area combined with multiple spinal anomalies in the thoracic and lumbar spine. The 22 year old female had cosmetic repair of the isolated skin appendage.
Conclusions: Neurosurgery and plastic surgery collaborated for excision and reconstruction. Human tail soft tissue anomaly as well as the spinal dysraphism can be successfully managed with a low rate of morbidity.
Patient Care: Improve treatment results of rare congenital cases.
Learning Objectives: Show benefits of multidisciplinary treatment of patients presenting with a "human tail".