The Human Tail: A Simple Skin Appendage or Cutaneous Stigma of an Anomaly?

The human tail is a term to describe skin-covered protrusions in the lumbosacral and coccygeal region, ascribing to the resemblance to the tails in the animals. The first reports dates back to second half of the 19th century, the etiological bases could not been ascertained yet. They are mainly classified as true or pseudo-tails.

Five cases with human tails were diagnosed and managed in our hospital between 2010 and 2014. Their demographic and lesion characteristics are presented.

Three of the 5 cases were male patients. The ages ranged between 1 day and 50 years at the time of diagnosis. The patients were diagnosed basically by the external appearance of the lesions without neurological deficits. Detailed examination revealed several associated lesions: two dermal sinus tracts, one tethered spinal cord and one club-foot in one-day preemie. Two patients had true and 3 had pseudo-tails. Four of them underwent surgery but the last one did not accept surgery. Surgery consisted of simple excision of the lesion in 2 patients with true tails and excision and removal of dermal sinus tract and untethering when necessary in the other 2 pseudo-tails.

The presented study indicated that true human tails are simple skin appendages without any associated spinal anomalies. However, pseudo-tails are potentially complex lesions with a high risk of spinal dysraphisms; warranting further diagnostic work-up and more extensive surgical technique if necessary. The key to managing human tails is making a clear distinction between true tails and pseudo-tails.