Yamatani K, Saitoh T, Oi M, Oka N, Endoh T, Takaku A
Department of Neurosurgery, Toyama Medical and Pharmaceutical University Faculty of Medicine.
No Shinkei Geka. 1991 Jan;19(1):93-6.
A human tail is a rare anatomical curiosity. A case of a human tail associated with lipomyelomeningocele is reported. The made subject was born, by breech delivery, at the 39th-week with a 3,008 g body weight. He was admitted to our hospital because of the presence of a human tail and subcutaneous mass in the midline lumbosacral region. The tail was about 7.5 cm in length and 2 cm in diameter. It was elastic and covered by normal skin. No systemic anomaly was found. Spina bifida below L5 was revealed, and no bony shadow was found on the plain X-ray film. CT scan showed a low density area in the spinal canal between L3 and lower sacral region that extended into the tail through the spina bifida. MRI also revealed intraspinal long T2 mass which was attached to the spinal cord and extended into the tail. Myelogram indicated intradural extramedullary mass below the L3 level. Surgical treatment was performed on the 3rd month of life with a diagnosis of a human tail with lipomyelomeningocele. At surgery, the tail was found to consist mainly of lipomatous tissue which extended subcutaneously and entered the spinal canal through the spina bifida. The tail and subcutaneous lipomatous tissue were totally excised. The capsule of subcutaneous lipomatous tissue was followed circumferentially down into the spinal canal, and found to be transformed to arachnoid membrane. Intradural lipomatous tissue was excised piece by piece, leaving only a small remnant attached to the conus medullaris to preserve sacral nerve root function.(ABSTRACT TRUNCATED AT 250 WORDS)
人类尾巴是一种罕见的解剖学奇象。本文报告一例与脂肪脊髓脊膜膨出相关的人类尾巴病例。该病例为一名39周臀位分娩出生的男婴,体重3008克。他因腰骶部中线处存在人类尾巴及皮下肿块入院。尾巴长约7.5厘米,直径2厘米。质地有弹性,表面覆盖正常皮肤。未发现全身异常。X线平片显示L5以下脊柱裂,未见骨质阴影。CT扫描显示L3至骶骨下部椎管内低密度区,经脊柱裂延伸至尾巴。MRI也显示脊髓内长T2信号肿块,附着于脊髓并延伸至尾巴。脊髓造影显示L3水平以下硬膜内髓外肿块。患儿出生3个月时接受手术治疗,诊断为脂肪脊髓脊膜膨出伴人类尾巴。手术中发现尾巴主要由脂肪组织构成,皮下延伸并经脊柱裂进入椎管。尾巴及皮下脂肪组织被完全切除。沿皮下脂肪组织包膜环形向下追踪至椎管,发现已转化为蛛网膜。硬膜内脂肪组织逐块切除,仅留一小部分附着于脊髓圆锥以保留骶神经根功能。(摘要截选于250字)