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Published on: March 24, 2020
Lipomatous lumbar mass with an attached digit and associated split cord malformation
C M H Snelling1, P M Ellis, R M L Smith
1Department of Pathology and Molecular Medicine, Queen's University and Kingston General Hospital, Kingston, Ontario, Canada.
Background:
A male infant was born with a digit attached to a skin-covered lumbar lipomatous mass and an underlying split cord malformation.
Methods:
Surgical removal of the mass was performed at four months-of-age. By this time the digit had grown a nail and imaging and histology showed ongoing development of articulated phalanges.
Results:
The lipomatous mass contained a long bone, a clavicle- and scapula-like structure and a variety of other mature germ layer derivatives. These features raised a number of diagnostic considerations, including: mature teratoma, hamartoma, rudimentary parasitic twin, lipomyelomeningocele and dorsal accessory limb.
Conclusions:
Based on review of the literature, the authors hypothesize that there is a pathogenetically related spectrum of skin-covered dorsal mass lesions, often associated with spinal dysraphism. These consist of a major lipomatous component and a variety of mature germ layer derivatives that can vary widely in their degree of anatomical organization from case to case.