A rare complex association of dermal sinus tract, dermoid cyst, filum terminale lipoma, tethered spinal cord and syringomyelia: A case report and literature review

Background

Dermal sinus tract is a rare type of spinal dysraphism. It is usually associated with other types of spinal congenital anomalies. This work shows the rare co-occurrence of primary and secondary neurulation defect in a single patient.

Case presentation

We introduce a 2 year old boy who presented with a sacral dimple. He had a complex underlying spinal neural tube defect, dermal sinus tract, dermoid cyst, filum terminale lipoma, tethered spinal cord and syringomyelia. He was managed with excision of the dermal sinus tract, dermoid cyst and filum terminale lipoma with untethering of the spinal cord. He had a good post operative outcome without any neurologic deficit.

Conclusion

This case shows how a simple skin dimple can be an indicator of underlying complex spinal dysraphism. It also shows the co-occurrence of primary and secondary neurulation defect which suggests the complex nature of the neurulation process.