A Case Report of Congenital Dermal Sinus Tract with Dermoid Cyst and Lipoma

Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. CDST is commonly associated with other pathologies such as myelomeningocele, split cord malformation, tethered cord and inclusion tumors. The authors report a case of a 2-year-old girl discharging lumbosacral CDST. The preoperative MRI showed the dermal sinus tract with 2 intradural lesions from L1 to L3. The tract was surgically excised followed by complete excision of the cyst and lipoma. The dermal sinus tract was attached to the medullary cone and was cut there, allowing “en bloc” removal of the dermal sinus tract. There were two distinct types of tumor. One cystic is located posterior to the medullary cone and the other is located laterally to the medullary cone, whose appearance suggests a lipoma. Both tumors were removed completely. The dura was closed in a tight manner. The pathological examination confirmed the lipoma and Dermoid Cyst. In the postoperative course, the child had a motor deficit in the lower limbs, which recovered completely after 3 months of physiotherapy.