Mature Teratoma in the Fourth Ventricle of an Adult: Case Report and Review of the Literature

Drapkin, Allan J.; Rose, Walter S.; Pellmar, Monte B.

doi:10.1227/00006123-198709000-00024

Cited by 21 publications

(16 citation statements)

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“…9) Since then, 20 cases of midline posterior fossa teratomas have occurred, with a predominance of females, compared to the male predominance found in teratomas of the pineal and suprasellar regions. 5) Our case, a 20-dayold neonate, is the youngest patient so far to have such a lesion. 14) Teratomas are difficult to treat because of the usually large size at presentation and young age of the patient.…”

Section: Discussionmentioning

confidence: 79%

“…Immature teratomas, as in our case, are composed of immature and undifferentiated fetal tissues, and usually undergo malignant transformation so are occasionally referred to as malignant immature teratoma. 3) Twenty cases of midline posterior fossa teratomas have been reported, 13 cases were benign mature teratomas and six cases were immature malignant teratomas, 5,14) with one case not known. 5) Intracranial teratomas have three presentations in neonates.…”

Section: Discussionmentioning

confidence: 99%

“…3) Twenty cases of midline posterior fossa teratomas have been reported, 13 cases were benign mature teratomas and six cases were immature malignant teratomas, 5,14) with one case not known. 5) Intracranial teratomas have three presentations in neonates. 3,6,7) The first type is teratoma in patients who are either still born or die immediately after birth.…”

Section: Discussionmentioning

confidence: 99%

“…Only five of 13 patients with mature teratoma were alive during follow up. 5) Radical excision of the tumor, although difficult, is the ideal treatment of intracranial teratoma. 4) Adjuvant therapy using radiotherapy and chemotherapy is recommended in immature intracranial teratomas.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Midline Posterior Fossa Teratoma. Case Report.

Desai

Nadkarni

Muzumdar

et al. 2001

Neurol. Med. Chir.(Tokyo)

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Midline Posterior Fossa Teratoma. Case Report.

Desai

Nadkarni

Muzumdar

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…According to the literature, however, petrous bone affected primarily is extremely rare 1,2 . Decades ago, there were very few cases of patients who survived completely following surgical removal of intracranial teratomas with subsequent normal neurological development 3,4 . Advances in neuroradiology and microsurgical technique now permit sooner diagnosis and successful treatment in many of these patients 5 …”

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confidence: 99%

Surgical management of the petrous teratoma

Zhong

Zhu

2009

ANZ Journal of Surgery

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Surgical management of the petrous teratomaa ns_5022 653..654 Teratomas are a subgroup of germ cell tumours. Intracranial teratomas are rare, comprising approximately 0.5% of all intracranial tumours, which commonly involve the middle-line structures of the cranium. According to the literature, however, petrous bone affected primarily is extremely rare. 1,2 Decades ago, there were very few cases of patients who survived completely following surgical removal of intracranial teratomas with subsequent normal neurological development. 3,4 Advances in neuroradiology and microsurgical technique now permit sooner diagnosis and successful treatment in many of these patients. 5 A 4-year-old girl presented with a 3-week history of fever associated with headache and left-ear purulence, which had happened when the patient was 6 months old. Magnetic resonance imaging (MRI) demonstrated a large lesion of heterogeneous signal occupying the whole left middle fossa ( Fig. 1). Computed tomography (CT) scan depicted that the left petrous bone was eroded (Fig. 2). The size of the mass was about 4 cm in diameter.The lesion was totally removed by an infratemporal epidural approach. Excision of the tumour was started from the centre of the lesion. The skull base was reconstructed with a temporalis fascia, which had harvested at the beginning of the case, draped over the floor of the middle cranial fossa. Without cerebrospinal fluid (CSF) leak, acoustic disorder or facial palsy, the post-operative course of the patient, was uneventful. The symptom of ear discharge gradually disappeared within a week. The post-operative MRI confirmed an en bloc resection of the tumour. Microscopic examination supported the intraoperative diagnosis of mature teratoma.For those petrous teratomas confined to the epidural space, a middle fossa craniotomy via an extradural subtemporal approach is the choice. To achieve enough operative space, the bone of the Kawase triangle, 6 that is, delimited by the great superficial petrous nerve (GSPN) laterally, the porus trigeminus medially and the arcuate eminence at the base, can be drilled out firstly. To evade the important structures, there are three triangle-projections in the superficial petrous bone that should be localized before bone drilling: (1) the internal acoustic canal triangle, which is defined by the upper border of the meatus, the genu of petrous segment internal cartoid artery (ICA) and the intersection point of arcuate eminence and the drawn-out line of the GSPN; (2) the cochlear triangle, which is delineated by the meatus of the GSPN canal, the genu of petrous segment ICA and the intersection point of arcuate eminence and the drawn-out line of the GSPN; and (3) the petrous ICA triangle, which Fig. 1. T1-weighted axial magnetic resonance image with contrast depicting a large lesion of heterogeneous signal occupying the whole left middle fossa (asterisk labelled the centre of the lesion).Fig. 2. CT scan demonstrating the lesion eroding the left petrous bone (asterisk labelled the centre of the le...

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