Teratoma in Split Cord Malformation: An Unusual Association: A Report of Two Cases with a Review of the Literature

Tk, Maiti; Bhat, DI; Bi, Devi; Somanna, Sampath; Mahadevan, Anita; Sk, Shankar

doi:10.1159/000320386

Cited by 15 publications

(5 citation statements)

References 23 publications

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“…[5–13] Common associations are MMC,[56] lipoma,[7–9] teratomas[10–12] and neuroenteric cyst. [13] Among the MMC, SCM is reported in 10% cases.…”

Section: Discussionmentioning

confidence: 99%

Split cord malformation – A study of 300 cases at AIIMS 1990– 2006

Mahapatra

2011

J Pediatr Neurosci

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Background:Split cord malformation (SCM) is a rare condition. With decreasing incidence of neural tube defect (NTD) in the West, the reports of SCM are getting lesser and lesser. However, in India, spinal dysraphism is still a major problem encountered by the neurosurgeons.Objective:Our aim was to analyze 300 patients of SCM for their clinical features, radiological findings and outcome of surgery, which can throw light on the subject to others, who have less scope of finding these cases frequently.Materials and Methods:Over a 16-year period, we encountered 300 cases of SCM at AIIMS. Over the same period, more than 1500 cases of NTD were managed. SCM was noticed in 20% of cases with NTD. Skin stigmata were noted in two-third of the cases, and scoliosis and foot deformity were observed in 50% and 48% cases, respectively. Motor and sensory deficits were observed in 80% and 70% cases, respectively. Commonest site affected was lumbar or dorsolumbar (55% and 23%, respectively). In 3% cases, it was cervical in location. Magnetic resonance imaging (MRI) scan revealed a large number of anomalies like lipoma, neuroenteric cyst, thick filum and dermoid or epidermoid cysts. All the patients were surgically treated. In type I, bony spurs were excised, and in type II, bands tethering the cord were released. Associated anomalies were managed in the same sitting. Patients were followed up from 3 months to 3 years.Results:Overall improvement was noticed in 50% and stabilization in 44% cases and deterioration of neurological status was recorded in 6% cases. However, 50% of those who deteriorated improved to preop status prior to discharge, 7-10 days following surgery.Conclusions:SCM is rare and not many large series are available. We operated 300 cases and noticed a large number of associated anomalies and also multilevel and multisite splits. Improvement or stabilization was noted in 94% and deterioration in 6% cases. We recommended prophylactic surgery for our asymptomatic patients.

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“…[5–13] Common associations are MMC,[56] lipoma,[7–9] teratomas[10–12] and neuroenteric cyst. [13] Among the MMC, SCM is reported in 10% cases.…”

Section: Discussionmentioning

confidence: 99%

Split cord malformation – A study of 300 cases at AIIMS 1990– 2006

Mahapatra

2011

J Pediatr Neurosci

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“…Spinal teratomas are rare condition, associated with spinal dysraphism. [8,34,35] We have operated more than 10 teratomas in last 10 years. [8,35] In one of our patient, a one-year-old child, the teratoma recurred in 1 year time and the patient needed repeat surgery.…”

Section: Controversies: Related To Managementmentioning

confidence: 99%

Spinal dysraphism controversies: AIIMS experiences and contribution

Mahapatra

Pang²,

Nl³

et al. 2012

IJNS

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A large series of split cord malformation (SCM). Over the last 22 years, we have operated more than 1500 patients of SD, of which over 450 are (SCM), and 300 are with various lipomatus malformations. About 55% type II and 45% type I SCM. A separate sub-classification of type I SCM (a,b,c and d), is presented which alter the surgical approach and influence the results. Overall improvement following surgery in patients with SCM was observed in 94%. Fifty percent patients improved and 44% remained stable. However, deterioration was noticed in 6%, mostly with composite type of SCM. A paradigm for management of SCM is provided taking into consideration also the author’s large experience.

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“…Teratomas also show variable occurrence of tissues that are not native to the spinal or paraspinal region, such as thyroid follicles and mucus-secreting glands. 3,7,14 Dermoids and epidermoids, on the other hand, contain only ectodermal derivatives. 4 One of the first mentions of a spinal cord hamartoma was by Till in 1969 in a report of 3 cases within a series of 61 cases of tethered conus.…”

Section: Discussion Histopathologymentioning

confidence: 99%

Spinal intramedullary hamartoma with acute presentation in a 13-month old infant: case report

Samak¹,

Latif²,

Ghany³

et al. 2016

PED

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True hamartomas of the spinal cord are very rare, and although several have been reported in the literature, there are few detailed radiological and pathological descriptions of the condition. There is also considerable overlap with other entities, the most common being spinal cord teratomas. The authors report the case of a 13-month-old child with a supragluteal sacral dimple who presented with acute neurological deterioration. MRI of the spine revealed a big intramedullary lesion with heterogeneous signal intensity. A near-total resection was performed, and histopathological examination demonstrated findings consistent with a spinal cord hamartoma. The authors believe that careful preoperative evaluation and rigorous pathological examination are mandatory to establish diagnosis and direct further management of cases in which such a lesion is suspected.

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Teratoma in Split Cord Malformation: An Unusual Association: A Report of Two Cases with a Review of the Literature

Cited by 15 publications

References 23 publications

Split cord malformation – A study of 300 cases at AIIMS 1990– 2006

Split cord malformation – A study of 300 cases at AIIMS 1990– 2006

Spinal dysraphism controversies: AIIMS experiences and contribution

Spinal intramedullary hamartoma with acute presentation in a 13-month old infant: case report

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