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In utero Diagnosis of Spinal Dermal Sinus.
Apte, Anisha; Fauser, Tobias; Carson, Quinlan; Liechty, Kenneth W; Simpson, Lauren N; Avellino, Anthony M.
Afiliação
  • Apte A; Department of Surgery, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
  • Fauser T; Department of Surgery, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
  • Carson Q; Department of Pathology, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
  • Liechty KW; Department of Surgery, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
  • Simpson LN; Department of Neurosurgery, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
  • Avellino AM; Department of Neurosurgery, University of Arizona Tucson College of Medicine, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona, USA.
Fetal Diagn Ther ; 51(3): 235-242, 2024.
Article em En | MEDLINE | ID: mdl-38402872
ABSTRACT

INTRODUCTION:

Congenital dermal sinus (CDS) is an open neural tube defect (NTD) that occurs in 1 in 2,500 births a year and often goes undetected until patients present with complications like infection and neurological deficits. Early diagnosis and repair of CDS may prevent formation of these complications. In utero diagnosis of these lesions may improve long-term outcomes by enabling referral to specialty services and planned postnatal repair; however, only 2 such cases have been reported in the literature. We present a third case of in utero diagnosis of CDS with a description and discussion of findings from surgical exploration and pathology. CASE PRESENTATION Routine prenatal ultrasound scan detected a tethered cystic structure arising from the back of the fetus at 20 weeks of gestation. Dedicated fetal ultrasound confirmed the presence of a cystic lesion protruding through a lamina defect, while fetal magnetic resonance imaging showed an intact spinal cord and meninges, suggesting a diagnosis of CDS. Neurosurgery followed along closely and took the child for surgical exploration on day 2 of life. A fibrous stalk with an intradural component and associated cord tethering was excised. Histology showed fibrous tissue without an epithelial-lined lumen.

CONCLUSION:

CDS is a form of NTD that occurs from nondisjunction of the cutaneous ectoderm and neuroectoderm during formation of the neural tube. Slight differences in how this error occurs can explain variations seen in this spectrum of disease, including CDS without an epithelial-lined lumen as seen in this case. Newborns with CDS can go undiagnosed for years and present with long-term complications. Fetal imaging can assist in early recognition and surgical excision of CDS in newborns.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Espinha Bífida Oculta / Ultrassonografia Pré-Natal Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Espinha Bífida Oculta / Ultrassonografia Pré-Natal Limite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2024 Tipo de documento: Article