Congenital dermal sinus tract

Case contributed by Dalia Ibrahim

Presentation

Presented with upper back skin tag since birth.

Patient Data

Age: 3-year-old
Gender: Female
mri

Dermal sinus tract extends from the skin surface to the dorsal spinal cord opposite D3 via the widened D2/3 interspinous space, the dorsal spinal cord opposite D3 shows intramedullary increased signal (cord malacia)

Association: Unfused posterior arches (spinous processes) of C6 down to D4 vertebrae (Spina bifida occulta.

Dermal sinus tract extends from the skin surface to the dorsal spinal cord opposite D3 via the widened D2/3 interspinous space, the dorsal spinal cord opposite D3 shows intramedullary increased signal (cord malacia)

Association: Unfused posterior arches (spinous processes) of C6 down to D4 vertebrae (Spina bifida occulta)

x_ray

Unfused posterior arches (spinous processes) of C6 down to D4 vertebrae (Spina bifida occulta)

Photo

Photo: Skin tag.

Annotated images show: dermal sinus tract extends from the skin surface to the dorsal spinal cord opposite D3 via the widened D2/3 interspinous space (Red arrows), the dorsal spinal cord opposite D3 shows intramedullary increased signal (cord malacia)

Association: Unfused posterior arches (spinous processes) of C6 down to D4 vertebrae (Spina bifida occulta)

Case Discussion

Spinal dorsal dermal sinus is a rare entity, which usually comes to clinical attention by cutaneous abnormalities, neurologic deficit, and/or infection. 1

Spinal dorsal dermal sinus tract (DST) is a rare congenital dysraphism that occurs in approximately one in every 2500 live births

It includes a tract lined by epithelium, which traverse for a variable depth into the underlying structures and in many instances, terminate within the thecal sac.

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