Conflicting diagnosis of dermal sinus tract and tethered cord.

spinal dysraphism that is attributed to incomplete neural tube closure during fetal development. Dermal sinus tracts are found along the midline neuroaxis from the nasion to the coccyx, but they most commonly appear in the lumbar region.1 Dermal sinus tracts are more commonly associated with other developmental abnormalities such as skin tags, naevi, spinal dermoid cysts, meningocoele, lipomas and spinal cord tethering, and can be complicated by cerebrospinal fluid drainage, shedding of keratin from the epithelialized tract, and infection such as meningitis.1 We report a case of a radiologically diagnosed DST associated with multifocal dermal and subcutaneous hemangiomas. Surgical intervention demonstrated that despite high-resolution magnetic resonance imaging (MRI) showing intradural extension of the tract to the conus, intradural exploration revealed no such tethering tract. This unusual condition was successfully managed by surgical excision of pathological tissues.