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Human tail-like cutaneous appendage with a contiguous stalk of limited dorsal myeloschisis

  • Mio Sarukawa
  • Takato MoriokaEmail author
  • Nobuya Murakami
  • Takafumi Shimogawa
  • Nobutaka Mukai
  • Noriko Kuga
  • Satoshi O. Suzuki
  • Koji Iihara
Original Article

Abstract

Purpose

Limited dorsal myeloschisis (LDM) is characterized by a fibroneural stalk linking the skin lesion to the underlying spinal cord. On account of the external skin lesion, all LDMs are either flat (nonsaccular) or saccular, and a human tail-like cutaneous appendage has not been reported.

Methods

In our 14 LDM patients, 2 had tail-like appendages. We retrospectively analyzed the relationship between the appendage and the LDM tract from the clinicopathological findings of these 2 patients.

Results

Preoperative magnetic resonance imaging including three-dimensional heavily T2-weighted images demonstrated an intradural tethering tract, but failed to reveal the precise communication with the appendage. However, surgery revealed the extradural and intradural slender stalk, starting at the base of appendage and running through the myofascial defect. Histological examination demonstrated that there was a tight anatomical relationship between the fibroadipose tissue of the appendage and the fibrocollagenous LDM stalk.

Conclusion

When there is potential for an LDM stalk in patients with an appendage, a meticulous exploration of the stalk leading from an appendage is required. Clinicians should be aware of possible morphological variations of skin lesions associated with LDM.

Keywords

Glial fibrillary acidic protein Fibroneural stalk Untethering Fibroadipose tissue 

Notes

Acknowledgments

We thank Drs. Nobuko Kawamura, Ayumi Tsukamoto, and Ryutaro Kira for supporting our study. We also thank Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding information

This work was partly supported by the Research Foundation of Fukuoka Children’s Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric NeurologyFukuoka Children’s HospitalFukuokaJapan
  2. 2.Department of NeurosurgeryFukuoka Children’s HospitalFukuokaJapan
  3. 3.Department of Neurosurgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  4. 4.Department of General Pediatrics & Interdisciplinary MedicineFukuoka Children’s HospitalFukuokaJapan
  5. 5.Department of Neuropathology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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