You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
terminal myelocystoceles ( tmcs ) constitute approximately 5% of skin - covered lumbosacral masses and are especially common in patients with cloacal exstrophy .
they are defined as occult spinal dysraphism with a localized , cystic dilatation of the central canal of the spinal cord herniated through a posterior spina bifida .
tmc , truly an anomaly of the caudal cell mass , can be associated with anomalies of the anorectal system , lower genitourinary system , and vertebrae .
as is in our case , it may be associated with a lipoma which ends at the neural placode , when the term lipomyelocystocoele is applied . here
we present a rare and interesting case of giant terminal lipomyelocystocoele with syrinx and associated partial sacral agenesis .
a 6-month - old female child presented with a progressively increasing lumbosacral swelling which was present since birth [ figure 1 ] .
the child was a full - term normal vaginal delivery and had normal developmental milestones .
the patient had a weakness in ankle movement in both the lower limbs since birth .
, there was a soft lumbosacral mass measuring 14 cm  12 cm  10 cm in size , obliterating the intergluteal cleft and with normal skin on its surface .
lumbosacral mass obliterating the inter - gluteal cleft computed tomography and magnetic resonance imaging ( mri ) revealed a giant terminal lipomyelocystocele [ figures 2 and 3 ] which contained a trumpet like flaring of the central canal of the distal spinal cord and a meningocele located around the dilated central canal , which bulged into the subcutaneous region along with subcutaneous fat tissue .
associated features of partial sacral agenesis in the form of absent dorsal and left sided elements were noticed .
caudal portion of trumpet shaped myelocystocele was resected and the remaining base was repaired using 60 monocryl suture .
computed tomography scan showing spina bifida with the presence of trumpet like out - pouching of spinal contents magnetic resonance imaging t2 weighted sagittal section confirming the presence of terminal myelocystocoele post - operatively the child had wound infection , which required secondary suturing .
histopathology confirmed the findings of meningeal tissue with adipose and few wavy nerve fibers [ figure 4 ] .
myelocystocoeles are defined as localized cystic dilatation of the central canal of the spinal cord .
no true sex preponderance has been described.[35 ] the tmc is composed of a low - lying conus medullaris with cystic dilatation of caudal central canal , a surrounding meningocele , and a lipoma that extends from the conus to a subcutaneous fat collection .
the terminal cyst is lined with ependymal and dysplastic glia and does not communicate with the subarachnoid space .
essential features are present in all tmcs and constitute the core malformation , comprising an elongated spinal cord extending extraspinally into a cerebrospinal fluid - filled cyst that is broadly adherent to the subcutaneous fat .
the functional conus resides in the proximal cyst or within the intraspinal cord and the caudal myelocystocele wall is nonfunctional fibroneural tissue .
non essential features include variable measures of hydromyelia , caudal meningocele , and fat , present in only some patients .
if an insult disrupts retrogressive differentiation , regression fails to occur and an abnormally low conus results . according to pang et al .
, the core structure of tmc strikingly resembles a transitory stage of late secondary neurulation in chicks in which the cerebrospinal fluid - filled bleb - like distal neural tube bulges dorsally to fuse with the surface ectoderm before focal apoptosis detaches it from the surface and undertakes its final dissolution .
author theorizes that tmc results from a time - specific paralysis of apoptosis just before the dehiscence of the cystic distal cord from the future skin , thereby preserving the embryonic state .
the majority of children present with a skin covered mass at the lower back , in the intergluteal cleft and may be of variable size .
oeis ,  a complex which is described in the literature as including an omphalocele defect , exstrophy of the bladder , imperforate anus and spinal abnormalities , occurring together in the same patient .
many newborns with tmc have no neurological deficits but develop them with age . as the spinal cord is tethered in tmc , a slow neurological deterioration is expected with age , but some infants have precipitous loss of leg and bladder functions in early life coinciding with rapid enlargement of the myelocystocele . a myelocystocele can be diagnosed prenatally with high resolution fetal ultrasonography .
mri is the best noninvasive modality to diagnose all of the components of a tmc and the associated central nervous system findings .
mri appearance is distinctive and is characterized by a " trumpet - like " flaring of the distal cord central canal into an ependyma - lined terminal cyst .
abnormalities of the vertebral column may occur and include lordosis , scoliosis and agenesis of the sacral parts .
tmc should be repaired within the first few months of life or once the diagnosis is made regardless of whether there are preexisting deficits .
the aim of the tmc repair is to create an internal milieu least conducive to resticking of the remaining neural tissue , with maximal elimination of any nonfunctional wall through the use of reliable intraoperative electrophysiology .
surgical correction of myelocystocele is not only for cosmetic reasons but also to untether the spinal cord prophylactically to prevent future neurological deterioration . during surgical corrections ,
it is important to perform a thorough intradural inspection to transect all adhesions , in order to prevent future deterioration due to the spinal cord re - tethering .
terminal myelocystoceles ( tmcs ) are a rare form of occult spinal dysraphism . 
 they constitute approximately 5% of skin covered lumbosacral masses . 
 the tmc is composed of a low - lying conus medullaris with cystic dilatation of caudal central canal , a surrounding meningocele and a lipoma that extends from the conus to a subcutaneous fat collection . 
 a 6-month - old female child presented with a large lumbosacral mass ( 14 cm  12 cm  10 cm ) and weakness at the ankle joints since birth . 
 magnetic resonance imaging and computed tomography scan revealed a low - lying terminal lipomyelocystocele with holocord syrinx and partial sacral agenesis . 
 the child was operated on successfully . 
 this is an interesting and rare case of giant terminal lipomyelocystocoele with syrinx and a partial sacral agenesis . 
 terminal lipomyelocystocele should be included in the differential diagnosis of congenital lesions presenting as a lumbosacral mass and operated early .