A case of post-rectal dermoid, removed by the parasacral route : with remarks on tumours of the sacro-coccygeal region / by Henry Rutherfurd, M.B., F.F.P. & S.G., Assistant Surgeon, Glasgow Royal Infirmary.

  • Rutherfurd, Henry.
Date:
[1900]
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Credit: A case of post-rectal dermoid, removed by the parasacral route : with remarks on tumours of the sacro-coccygeal region / by Henry Rutherfurd, M.B., F.F.P. & S.G., Assistant Surgeon, Glasgow Royal Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    adults should be carefully studied, because in some instances tliey may have been dermoids.” Tliis is the converse of Seim’s statement, and 1 am able to amplify it by the case of a lymph cyst or hygroma removed by me in the Eoyal Infirmary from the lumbo-sacral region in a boy of ten. The case had been refused operation elsewhere as a spina bifida, but the tumour, which consisted of tliree principal sacs con- nected centrally, was (piite superficial to the lumbar apo- neurosis. xVmong the structures leading to the inclusion of surface epidermis and the formation of true dernoids, there falls to be considered the post-anal dimple or foveola retro-analis. For an account of this structure and its relation to tlie termination of the spinal cord, I would refer to a paper by MM. Tourneux and tiermann in the Jmcrnal tie VAnatomic and dc la Physiol., vol. xxiii., “ Sur la persistance de vestiges medullaires coccygiens pendant toute la periode foetal chez riiomme, et sur le role de ces vestiges sur la production. des tumeurs sacro- coccygiennes congenitales.” Their researches have led these writers to the conclusion that the formation of the post-anal dimple is due to the comparative ascent of the lower termination of the spinal cord caused by the disproportionate growth in length of the spinal cord and the spinal column, and consequent dragging in of the soft tissues with which in its earlv embryonic stages the cord is in immediate relation. ]\Iore than one such puckering of the suiiace may be present, and there may result merely funnel-shaped depressions, or cysts more or less completely shut off from the surface. Ih’ofessor Cleland (Journal of Anat. and Phys., Vol. xvii., p. 290) calls attention to tlie co-existence in cases of well marked dim|)le of a straight and unduly short sacrum, and is of opinion that botli the dimple and the deformity of tlie sacrum are to be related to an arrested development of the notochord. The origin of sacral tumours is further complicated by the cases in which we have to do with an unmistakable adherent foetus, and which shade off into those where we seem to recognise more or less well-defined parts, organs or tissues, belonging to a second foetus; and this complexity is increased