Denouement and Discussion
(a) Tethering of the spinal cord may take place in association with diastematomyelia (Fig 2), spinal dermal sinus (Fig 3), and cutaneous hemangioma with an underlying lesion of the spinal cord (Fig 4). Progressive neurologic deficits of the lower limbs and severe bladder dysfunction leading to hydronephrosis may occur.(b) The most common solid tumor in neonates is a sacrococcygeal teratoma (Fig 1) presenting as a caudal mass within or below the intergluteal crease. This is in contrast to a lipomatous mass that lies above the intergluteal crease. Because it usually arises from the coccyx, the tumor spares the spinal column and canal. The incidence and severity of malignancy is related to the time of diagnosis, and, therefore, early recognition and total surgical excision of the mass is important.(c) An increased incidence of meningitis occurs in patients with a dermal sinus tract that connects
Elhassani SB, Feingold M. Picture of the Month. Am J Dis Child. 1988;142(12):1369–1370. doi:10.1001/archpedi.1988.02150120123055
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