Coccygeal dermal sinus

Case contributed by Dr Taher Gandhi

Presentation

A child presented with a cutaneous defect in intergluteal cleft since birth. No discharge from it. No associated pain. No neurological symptoms.

Patient Data

Age: 10 years
Gender: Female
MRI

A thin curvilinear tract is noted extending from the tip of the coccyx reaching upto the intergluteal cleft with dermal opening in right paramedian location. The tract appears hypointense on T2WI with no fluid within. Sclerosis of coccygeal spine in form of T2 hypointensity is noted. No surrounding inflammatory or abscess formation is noted. No evidence of spinal dysraphism is noted. 

Case Discussion

It is an epithelium-lined tract arising from coccyx with outside cutaneous opening. It is a congenital condition. It is relatively asymptomatic often presented with coccygeal pits and referred from neurosurgeon to rule out dural communicaton or spinal dysraphism or abscess formation. Dural connection is often presented with meningitis. MRI is used to rule out fistula in ano or an inflammatory sinus.  The tract will appear hypointense on T2WI extending from the tip of the coccyx reaching up to the intergluteal cleft with dermal opening. Surrounding inflammatory or abscess formation or spinal dysraphism or fistula should be evaluated properly.

Additional case author: Dr Trupti Sabalpara

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