A 5-year-old girl had a caudal appendage and her left buttock was larger than the right buttock. X-ray examination revealed spina bifida and bony defect of sacrum; computed tomography demonstrated the extension of the tumor from subcutaneous tissue to the spinal canal. Histologically, the pseudotail contained lobulated fatty tissue which was consistent with lipoma. It emphasizes the fact that even lesions that are not situated in the median line should be carefully explored before excision.
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