Robinson Caitlin G, Duke Taylor C, Allison Ashley W
The University of Texas Health Science Center at Houston, Department of Dermatology, Houston, TX, USA.
The University of Texas Health Science Center at Houston, The John P. and Kathrine G. McGovern Medical School, Houston, TX, USA.
J Cutan Pathol. 2017 Jan;44(1):75-78. doi: 10.1111/cup.12820. Epub 2016 Oct 20.
True human tails are rare vestigial structures that are typically removed in childhood. Here a case is presented in which an inconspicuous sacrococcygeal tail was incidentally discovered in late adulthood. A 56-year-old man with no significant past medical history presented to a dermatology clinic with a chief complaint of a hyperpigmented lesion on his central back. However, on full body skin exam, a separate flesh-colored 0.7 cm × 0.5 cm appendage was discovered in the midline sacrococcygeal region. This lesion had been present and unchanged since childhood. This particular lesion was removed via shave biopsy. Microscopic exam found it to be consistent with a diagnosis of a true human tail. There were no apparent involved spinal cord structures, and no further treatment was thought to be necessary. Human tails are congenital anomalies associated with occult spinal lesions in about 50% of cases. Therefore, it is in these patients' best interest to thoroughly evaluate for spinal cord involvement prior to biopsy. There is a relative lack of literature published on the topic, and a greater awareness of human tails would be helpful to ensure their inclusion in a differential diagnosis for persistent sacrococcygeal lesions in patients of any age.
真正的人类尾巴是罕见的退化结构，通常在儿童期就被切除。本文报告一例在成年后期偶然发现的不显眼的骶尾部尾巴病例。一名56岁男性，既往无重大病史，因背部中央色素沉着病变为主诉就诊于皮肤科诊所。然而，在全身皮肤检查中，在骶尾部中线区域发现了一个单独的肉色0.7厘米×0.5厘米的附属物。该病变自童年起就存在且未发生变化。通过削切活检切除了这个特殊病变。显微镜检查发现其符合真正人类尾巴的诊断。没有明显累及脊髓结构，并且认为无需进一步治疗。人类尾巴是先天性异常，约50%的病例与隐匿性脊柱病变相关。因此，在活检前对这些患者进行脊髓受累情况的全面评估符合他们的最大利益。关于该主题发表的文献相对较少，提高对人类尾巴的认识将有助于确保在对任何年龄患者的持续性骶尾部病变进行鉴别诊断时考虑到它们。
