Intramedullary Mature Teratoma of Cervical Spine in an Infant: A Rare Case Report

Abstract

Spinal Teratomas are rare tumor and cervical intramedullary location in infancy still rarer. Only eleven cases of cervical intramedullary teratoma in pediatric patients is reported in available literature (1, ll). We are reporting a case of an infant presenting with cervical mature teratoma with associated dysraphism, adding the next in this rare case series. Arising as a result of dysembryogenesis, these lesions by virtue of their content are difficult to diagnose preoperatively. Heterogeneous intensities on MRI produced by intralesional lipomatous and osseous elements are helpful but rarely enough to diagnose the tumor. Histology is confirmatory. Mature teratomas generally have good prognosis and a timely intervention can prevent further neurological deterioration. However a strict clinical and radiological follow up is recommended.

Adult-onset spinal teratoma: a case report and review

“…Lum bar spine MRI a, b -T2 sagittal and ax ial plane showed well de lin eated cys tic le sion; c -T2 TIRM se quence showed no intralesional fat; d -T1 sequence with fat sup pres sion af ter con trast ad mis sion showed no con trast en hance ment in the le sion [4]. In our re viewed lit er a ture there was no con sen sus between au thors on the most com mon lo ca tion of spi nal teratoma: cer vi cal [14], tho racic [2,[15][16][17][18][19][20][21][22][23][24], lum bar [1,2,[15][16][17][18][19][20][21][22][23][24] or co nus [1,14]. No sex spe cific dif fer ences were found in spi nal teratoma in ci dence [4] but there is a sig nif icant dif fer ence in mean age at the time of di ag no sis between male and fe male: 36.4±12.3 years for men and 41.3±11.6 for women [4].…”

“…No sex spe cific dif fer ences were found in spi nal teratoma in ci dence [4] but there is a sig nif icant dif fer ence in mean age at the time of di ag no sis between male and fe male: 36.4±12.3 years for men and 41.3±11.6 for women [4]. Spi nal teratomas usu ally are not di ag nosed pre op er a tively due to their rar ity [1,10].…”

“…Teratoma is de fined as a neo plasm that is com posed of a vari ety of parenchymal cell types de rived from three ger mi nal lay ers (ectoderm, endoderm, and mesoderm) and can oc cur at many lo ca tions through out the body [1][2][3][4]. Teratoma rarely oc curs in the cen tral ner vous sys tem (only 2% of all teratomas) [5] and it con sti tutes only 0.1-0.5% of all spi nal cord tu mors [2,[4][5][6][7].…”

“…Clas si cally, teratomas are di ag nosed when rem nants of all three germ lay ers are present (ectoderm, mesoderm an endoderm) [1,5,6,32,35], how ever some au thors have noted that in some cases it might be dif fi cult to de ter mine all three lay ers be cause of the over growth of 1 or 2 lay ers, thus it have been sug gested that the spi nal teratoma di ag no sis can not be dem on strated in the histological sam ple [5]. Spi nal teratomas are clas sified into 3 types ac cord ing to the de gree of dif fer en ti a tion: ma ture, im ma ture and ma lig nant [1,23,36]. Histologically ma ture teratoma pres ents with rec og niz ably dif fer en ti ated tis sues [10].…”

“…Im ma ture teratomas are com posed of prim itive, un dif fer en ti ated com po nents [10]. This type of teratoma is prone to fre quent re cur rence and ag gres siveness [1]. Ma lig nant teratomas are de rived from endodermal si nus or yolk sack and may be as so ci ated with a poor prog no sis, es pe cially along with high lev els of se rum E-fetoprotein [25,28].…”