Lateral congenital spinal dermal sinus

Carrillo, R.; Carreira, L. Miguel; Prada, José J.; Rosas, Cesareo

doi:10.1007/bf00270770

Cited by 25 publications

(22 citation statements)

References 5 publications

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“…Controversy regarding an association with OSD and the proper evaluation and management of isolated cutaneous defects in the coccygeal region exists. 13,[15][16][17][18][19][20][21][22][23] Given the relative frequency of these cutaneous abnormalities, any statement requiring diagnostic evaluation is of public health concern. Based on our studies, it becomes difficult to recommend surgical treatment or even radiographic evaluation for isolated coccygeal pits.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors argue that the presence of any cutaneous abnormality in the gluteal region warrants radiographic and/or surgical evaluation because of a suspected association with abnormal communications with or various abnormalities of the contents of the intraspinal cavity. 13,[15][16][17][18] Some clinicians suggest that the respective appearance of the lesion should determine its further work-up. Lesions are inspected for the ability to discern the cutaneous base or for the presence of hair.…”

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confidence: 99%

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Coccygeal Pits

Weprin

Oakes

2000

Pediatrics

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ABSTRACT. Background. Congenital dermal sinuses represent cutaneous depressions or tracts that are lined by stratified squamous epithelium. They communicate between the surface of the skin and deeper structures and may occur anywhere along the craniospinal axis. These sinuses are thought to result from abnormal separation of the cutaneous and neural ectoderm between the third and fifth week of intrauterine life. They may be often accompanied by other cutaneous stigmata, various dysraphic abnormalities, or intraspinal tumors.In the sacrococcygeal area, cutaneous congenital abnormalities are relatively common. It is estimated that 2% to 4% of children harbor intergluteal dorsal dermal sinuses. These intergluteal sinuses in the perianal region are frequently referred to as pits or dimples. Their cause is considered similar to other congenital dermal sinuses and appears unrelated to acquired pilonidal conditions observed in adults. They may become susceptible to local recurrent infection from trauma or hirsutism.Controversy regarding the evaluation and management of cutaneous defects in the coccygeal region exists.Methods. Both a literature review and a career review of clinical material were performed. Databases for articles published in English were surveyed for key words relating to coccygeal sinuses using standard computerized search techniques. The medical records of children presenting to our neurosurgical clinic for evaluation of dorsal dermal sinuses were reviewed to identify those with intergluteal sinuses.Results. In the evaluation of reported cases and of our own, we were unable to identify any children with coccygeal sinuses without other cutaneous markers other than hair with findings suggestive of intraspinal communication.Conclusions. Intergluteal dorsal dermal sinuses are relatively common lesions that frequently come to neurosurgical attention.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Coccygeal Pits

Weprin

Oakes

2000

Pediatrics

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“…11,24,38 Paramedian congenital dermal sinuses in which there were multiple or laterally located dermal sinuses have also been reported in the literature. 7,10,18 The recommended treatment of CDSs with recurrent infections is resection. In the presence of communication with the thecal sac, intradural exploration must be performed.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of congenital dermal sinus: tethered spinal cord with intradural epidermoid and dual paramedian cutaneous ostia

Cox

Knudson²,

Manjila³

et al. 2012

FOC

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The authors present the first report of spinal congenital dermal sinus with paramedian dual ostia leading to 2 intradural epidermoid cysts. This 7-year-old girl had a history of recurrent left paramedian lumbosacral subcutaneous abscesses, with no chemical or pyogenic meningitis. Admission MRI studies demonstrated bilateral lumbar dermal sinus tracts and a tethered spinal cord. At surgery to release the tethered spinal cord the authors encountered paramedian dermal sinus tracts with dual ostia, as well as 2 intradural epidermoid cysts that were not readily apparent on MRI studies. Congenital dermal sinus should be considered in the differential diagnosis of lumbar subcutaneous abscesses, even if the neurocutaneous signatures are located off the midline.

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“…[3][4][5] Laterally placed CDS in the buttocks is extremely rare, with only 5 cases reported. 2,3,7) We describe a sixth case of lateral CDS in the gluteal region presenting with infection, and illustrate the neuroimaging and surgical findings of this rare entity.…”

Section: Introductionmentioning

confidence: 96%

“…The sinus tract blindly ends in the subcutaneous tissue in some cases. 2,3,5) The most accepted etiology of CDS involves non-disjunction theory; a failure of separation between the neuro-and cutaneous-ectoderm in the midline results in persistent ectodermal tissue between the skin and neural elements between the third and fifth weeks of gestation. 1,5,9) Therefore, the dimple will usually be found in the midline along the spinal axis.…”

Section: Introductionmentioning

confidence: 99%

Lateral Buttock Congenital Dermal Sinus Tract -Case Report-

Yamaguchi

Takeda

Kihara

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 6-month-old female presented with purulent discharge from a dimple in the right lateral buttock. A subcutaneous abscess was palpated on the right paravertebral region at the L5-S1 level. She had lowgrade fever with laboratory findings of leukocytosis and elevation of C-reactive protein levels. Klebsiella and Enterococcus species were cultured from the pus. Computed tomography (CT) clearly showed a tract traversing the subcutaneous tissue and connecting to the abscess. Magnetic resonance (MR) imaging showed no abnormality in the spinal canal. The diagnosis was infected congenital dermal sinus (CDS) in the right buttock. After normalization of body temperature and laboratory findings in response to antibiotic treatment, the dermal sinus tract was surgically removed. Intraoperative findings showed that the tract gradually tapered and ended at the subcutaneous abscess space over the lumbosacral fascia. Histological examination confirmed the lesion was dermal sinus. Although laterally placed CDS in the buttocks is extremely rare with only 5 previous cases reported, lateral CDS should be included in the differential diagnosis of a dimple in the buttocks. CT as well as MR imaging should be performed to evaluate suspected lateral CDS.

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Lateral congenital spinal dermal sinus

Abstract: Two children with spinal dermal sinuses of congenital origin are described. They are unusual because the skin dimples were located off the midline at the gluteal region.

Cited by 25 publications

References 5 publications

Coccygeal Pits

Coccygeal Pits

Unusual presentation of congenital dermal sinus: tethered spinal cord with intradural epidermoid and dual paramedian cutaneous ostia

Lateral Buttock Congenital Dermal Sinus Tract -Case Report-

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