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 Table of Contents  
IMAGES IN ACADEMIC MEDICINE
Year : 2017  |  Volume : 3  |  Issue : 1  |  Page : 202-203

A human tail over the scapular region


1 Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India
2 Department of Pathology, Government Medical College, Haldwani, Uttarakhand, India

Date of Web Publication7-Jul-2017

Correspondence Address:
Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani - 263 139, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-5568.209858

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  Abstract 


Cutaneous appendages are uncommon anomalies reported as sporadic reports or small series in literature. Most of them resemble tail-like structure which ar arise in the midline and are associated with an underlying neuroanatomical anomaly in most instances. The presence of human tail-like structure over the scapular region is a rare event and has not been reported to the best knowledge of the authors.
The following core competencies are addressed in this article: Medical knowledge, Patient care.

Keywords: Anomaly, congenital, human tail, neonate, pseudotail


How to cite this article:
Dharmshaktu GS, Pangtey T. A human tail over the scapular region. Int J Acad Med 2017;3:202-3

How to cite this URL:
Dharmshaktu GS, Pangtey T. A human tail over the scapular region. Int J Acad Med [serial online] 2017 [cited 2019 Dec 13];3:202-3. Available from: http://www.ijam-web.org/text.asp?2017/3/1/202/209858


  Introduction Top


Human tail is an enigmatic clinical entity that may present itself as pseudo-tail or a true tail in accordance with its association with or without underlying neurological condition respectively. Most of the cases described in literature are located in lower back region as lumbar, lumbosacral, sacral or sacro-coccygeal structures. The examples of off the midline location of these tail is rarer and curious presentation.


  Case Report Top


A newborn was referred to us with bilateral congenital clubfeet and a tail-like structure over the right scapular region. The male newborn was the first child of otherwise normal parents and born through full-term normal delivery. There was no history of any complication during pregnancy and perinatal period. No relevant family history was present along with no radiation exposure or substance abuse. The child was healthy and was on exclusive breastfeeding. The tail, about 3 cm in length, was attached to the upper right corner of the scapular region and appeared to consist of chiefly fibrofatty tissue on palpation [Figure 1]. Chest radiograph showed the presence of both scapulae and no significant bony anomaly. As the structure was not midline and clinically not related to spinal structures, magnetic resonance imaging of the spine was not advised.
Figure 1: The clinical picture of human tail over the scapular region (above) with the measurement of the appendage (below)

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  Discussion Top


Human tail or dorsal cutaneous appendage is a rare anomaly and described either as true vestigial or pseudotail in literature.[1] A feature of embryonic development, fetal tail, remains as remnant in the form of coccyx and persistence of it denotes distal nonvertebrate remnant.[2] True tails contain muscle fibers, nerves, vessels, and sometimes exhibit movement and are mostly benign appendageal prolongations whereas pseudotails are associated with underlying spinal anomalies.[3] Most commonly, they are reported in male children, over lower spinal or coccygeal region and associated with various neurodevelopmental anomalies.[4],[5] Thus, surgical excision warrants careful exclusion of underlying associated neuroanatomical malformation. The tails are mostly present over lumbar, lumbosacral, or coccygeal regions and their presence in areas other than these or the midline is exceptional [Table 1]. The presence of other congenital anomalies such as cleft palate, clubfoot, and syndactyly requires appropriate management. The presence of a skin tail over the scapular region is a very rare occurrence. The parents, however, wished to keep the tail intact as considered sacred in their religious belief. The clubfeet were satisfactorily managed by corrective serial casting.
Table 1: Selected recent reports of human tails or pseudotails (within the past 10 years)

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.[15]

 
  References Top

1.
Dao AH, Netsky MG. Human tails and pseudotails. Hum Pathol 1984;15:449-53.  Back to cited text no. 1
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2.
Zimmer EZ, Bronshtein M. Early sonographic findings suggestive of the human fetal tail. Prenat Diagn 1996;16:360-2.  Back to cited text no. 2
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3.
Ledley FD. Evolution and the human tail: A case report. N Engl J Med 1982;306:1212-5.  Back to cited text no. 3
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Robinson CG, Duke TC, Allison AW. Incidental finding of a true human tail in an adult: A case report. J Cutan Pathol 2016; doi: 10.1111/cup. 12820. [Epub ahead of print].  Back to cited text no. 12
    
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Mukhopadhyay B, Shukla RM, Mukhopadhyay M, Mandal KC, Haldar P, Benare A. Spectrum of human tails: A report of six cases. J Indian Assoc Pediatr Surg 2012;17:23-5.  Back to cited text no. 13
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14.
Mohindra S. The human tail causing tethered cervical cord. Spinal Cord 2007;45:583-5.  Back to cited text no. 14
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15.
Bhat AR, Raina TH, Arif S, Kirmani AR, Wani MA, Naqash I, et al. Gluteal pseudophallus in a male child: A rare cutaneous marker of occult spinal dysraphism. J Pediatr Neurosci 2009;4:127-30.  Back to cited text no. 15
[PUBMED]  [Full text]  


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Abstract
Introduction
Case Report
Discussion
Introduction
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