The human tail: a case series of five patients and a review of the literature.

PURPOSE: The human tail is a rare congenital anomaly in the lumbosacrococcygeal region, considered a remnant of the embryonic tail. These lesions can be associated with significant underlying pathologies like spinal dysraphism, necessitating thorough evaluation. This study presents five cases of human tail managed at our institution and provides a review of the relevant literature.

METHODS

The medical records of five patients who underwent surgical excision for a "human tail" between 2000 and 2015 were retrospectively reviewed. Data on patient demographics, lesion characteristics, radiological findings, surgical procedures, histopathological results, and follow-up outcomes were compiled and analyzed.

RESULTS

All five patients were in the pediatric age group (6 months to 10 years), comprising three females and two males. The primary complaint was a tail-like appendage in the lumbosacral area. The morphology and size of the lesions varied. An underlying tethered cord syndrome was identified in four of the five cases (80%). All patients underwent complete surgical excision. Histopathology revealed mature adipose tissue, fibrous connective tissue, blood vessels, and nerve fibers, with no bone or cartilage. No postoperative complications were observed, and excellent cosmetic outcomes were achieved.

CONCLUSION

The presence of a human tail is more than a cosmetic issue; it is a critical cutaneous marker for underlying neural tube defects. Every patient requires meticulous evaluation, primarily with spinal magnetic resonance imaging, and multidisciplinary management. Surgical excision offers effective cosmetic correction and prevents potential complications.