Introduction: Skin covered appendages of the lumbosacral and coccygeal regions are rare and considered human-tails. They can be classified as true-tails or pseudo-tails, whether they are independent from spinal canal and nervous tissue - true tails - or associated with other lesions, such as lipomas, teratomas or spinal dysraphism – pseudo-tails.

Case report: The authors report the case of a full-term newborn girl in whom skin inspection revealed a lumbar skin appendage, approximately 10 cm long, with a left para-median skin insertion and an irregular protrusion in its distal end, partially epithelialised. The neurological examination did not reveal any deficit, especially concerning lower limbs mobility and posturing. The magnetic resonance of the spine, performed in the first day of life, showed a dermal sinus continuous with the skin appendage and with extension into to the spinal canal, contacting the dura at L3-L4 level and a tethered cord. She underwent surgery with removal of the skin appendage and subcutaneous dermal sinus ligation on the second day of life, due to the risk of infection. Pathological examination showed a skin appendage and a distal end with connective tissue, adipose tissue islets and superficial infectious process. The post-operative period was uneventful. Due to the risk of future neurological deficits related to the spinal cord tethering, the child is being closely followed at the Pediatric Neurosurgery outpatient clinic.

Discussion: Although rare, lumbar skin appendages can be associated with spinal dysraphism and other lesions, requiring early attention and long-term surveillance.