Seol H J, Wang K C, Kim S K, Kim H, Choe G, Chi J G, Cho B K
Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Childs Nerv Syst. 2001 Dec;17(12):758-61. doi: 10.1007/s003810100464. Epub 2001 Apr 26.
Intramedullary teratoma is a rare lesion, located in the majority of cases in the lumbosacral area, and such lesions involving an extensive area of the spinal cord in young infants have seldom been reported. We present the case of a 3-month-old girl with an intramedullary spinal immature teratoma extending from C-5 to T-12, which was totally removed. The patient had suffered from paraplegia for 15 days, after which spinal MRI revealed a heterogeneously enhancing intramedullary lesion. Biopsy of the lesion demonstrated mature intestinal tissue. After total removal of the tumor, paraplegia and sphincter disturbances improved. Intramedullary teratoma should be included in the differential diagnosis of holocord tumors in young infants with rapidly progressing symptoms and if found should be radically excised. This case also emphasizes the importance of histological diagnosis and demonstrates the possibility of neurological recovery even in the case of paraplegia lasting for more than 1 month in a young infant.
髓内畸胎瘤是一种罕见的病变,大多数病例位于腰骶部,而累及幼儿脊髓广泛区域的此类病变鲜有报道。我们报告一例3个月大的女孩,患有从C-5至T-12的髓内脊髓未成熟畸胎瘤,该肿瘤被完全切除。患者曾患截瘫15天,之后脊髓磁共振成像显示髓内病变不均匀强化。病变活检显示为成熟的肠组织。肿瘤完全切除后,截瘫和括约肌功能障碍有所改善。对于症状迅速进展的幼儿全脊髓肿瘤,髓内畸胎瘤应列入鉴别诊断范围,一旦发现应彻底切除。本病例还强调了组织学诊断的重要性,并证明即使在幼儿截瘫持续超过1个月的情况下,神经功能恢复也是有可能的。