Little Hanuman: A Rare Case of Human Tail

Sir, An appendage on the back, also called as human tail, can be an ill-defined, finger-like, midline structure. An extremely interesting anomaly with a classification into true (vestigial) tail or pseudotail was observed.[1,2] Dao and Netsky[3] described the features to distinguish the true tails from the pseudotails. True tail would contain adipose and connective tissue, striated muscle, blood vessels, and nerves, and is covered by skin, whereas bone, cartilage, notochord, and spinal cord are lacking with the ability to move and contract. The pseudotail, on the other hand, is an anomalous prolongation of the coccygeal vertebra, lipoma, teratoma, or chondrodystrophy. The following is an extremely rare finding, with only 66 cases that have been reported in modern literature.[1] The finding is mostly never benign and is associated with occult spinal dysraphism, which needs further clinical and radiological evaluation. We present the following case of a four-month-old female child with a long 12-cm appendage attached to the back with no clinical deficit or symptom; on further examination, the imaging showed hyperintensity in the T1 sequence of MRI extending into the cord via an occult spinal dysraphism with a low-lying tethered cord [Figures 1-3]. The case is under evaluation and will be taken up for definitive procedure once the complete evaluation is performed.Figure 1: MRI imaging showing hyperintensity in the T1 sequence extending into the cord via an occult spinal dysraphism with a low-lying tethered cordFigure 2: MRI spine T2 axial image shows sacral spina bifida associated with a low-lying tethered cord and the placode–lipoma interface lying within the spinal canalFigure 3: Little Hanuman—a four-month-old female child with a long 12-cm appendage attached to the back with no clinical deficit or symptomHanuman, a central figure in Hindu mythology, is a devoted follower of Lord Ram and a symbol of strength, loyalty, and devotion. Known for his monkey-like appearance, Hanuman’s long tail holds deep symbolic meaning. It represents his boundless energy, agility, and spiritual power. In the Ramayan, his tail plays a crucial role when he sets Lanka ablaze to aid Ram in rescuing Sita. The tail’s length signifies his might and divine abilities, reminding devotees of the power of faith and courage. Hanuman’s enduring popularity lies in his embodiment of selfless service, making him a revered deity across Hindu traditions. Our little patient, though to the world, is suffering from a congenital abnormality and dealing with the social stigma surrounding it, but in our eyes, he embodies the brave Hanuman himself. Hereby, the authors present a rare case of a human tail, aka our little Hanuman! Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.