Thoracic Epidural Teratoma: Case Report and Review of the Literature

Abstract

PURPOSESpinal teratomas comprise a rare subset of spinal cord tumors, and here, we describe an even rarer childhood thoracic extradural–intracanalicular teratoma. The clinical presentation, management, and pathophysiology of these tumors are reviewed to promote recognition and guide treatment of these lesions.METHODSWe report the case of a 21-month-old boy who presented with marked spasticity, as well as failure to ambulate and meet motor milestones. Additionally, we provide a literature review of spinal teratomas, including their clinical presentation, work-up, pathophysiology, and underlying genetics.ResultsAn MRI of the spine revealed a large dorsal epidural tumor extending from T3 to T10 with heterogeneous contrast enhancement and severe spinal cord compression. The tumor was resected revealing a cystic mass with tissue resembling hair, muscle, as well as cartilage; pathology confirmed the diagnosis of teratoma. Gross total resection was achieved, and the child eventually gained ambulatory function.CONCLUSIONSGiven that spinal teratomas are rare entities that can present with significant neurologic compromise, they must remain on clinicians’ differentials. Unfortunately, the exact origin of these tumors remains inconclusive and requires further investigation.

Primary Extraskeletal Ewing Sarcoma of the Thoracolumbar Epidural Space: Rare Case Report in a Child

“…Therefore, the differential diagnoses may be: benign bone tumors (such as osteoid osteoma, osteochondroma, giant-cell tumor, aneurysmal bone cyst, and hemangioma), Langerhans cell histiocytosis, and fibrous dysplasia; and malignant tumors, such as sarcomas, teratomas, chordomas, and metastatic lesions. 11…”

“…Therefore, the differential diagnoses may be: benign bone tumors (such as osteoid osteoma, osteochondroma, giant-cell tumor, aneurysmal bone cyst, and hemangioma), Langerhans cell histiocytosis, and fibrous dysplasia; and malignant tumors, such as sarcomas, teratomas, chordomas, and metastatic lesions. 11 For the diagnosis, imaging techniques like CT be used to look for heterogeneous masses, and the MRI, for hypo-or isointense signals in T1-weighted images and hyperintense signals in T2-weighted images. Fluorodeoxyglucose positron emission tomography has not shown good results in the diagnosis and staging of soft-tissue sarcomas.…”

Extensive spinal epidural immature teratoma in an infant: case report

“…We reviewed the literature for cases of SET occurring in infants and summarized the characteristics of these cases in Table 1. 1,4,8,[11][12][13]15 We included teratomas inside the spinal canal without intradural extension, but excluded the intraspinal extension of the sacrococcygeal, retroperitoneal, and mediastinal teratomas. Several authors have reported that, with the exception of those originating from the sacrococcygeal region, spinal teratoma is rare.…”