Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Neurosurgery. 2010 Dec;67(6):E1818-25. doi: 10.1227/NEU.0b013e3181f846ca.
Of the 170 cases of teratomas in the spinal canal reported in the English literature, only 13 were spinal epidural teratomas (SETs). We present a case of SET, review the characteristics of SETs in comparison with spinal intradural teratomas (SITs), and investigate the pathogenesis of spinal teratoma.
A 17-month-old boy visited our clinic with paraparesis. A multicystic mass was noted in the left epidural space from T8 to T10 and the left paraspinal area. Complete resection of the tumor, including the paraspinal portion, was accomplished by laminoplastic laminotomy. The tumor was well encapsulated and filled with heterogeneous contents. The tumor was suspected to originate from the left T9 root.
On histopathological examination, the tumor was found to be a mature teratoma. The clinical characteristics of SETs and SITs show similarities in age, male preponderance, location, associated anomalies, and pathology. SETs and SITs are probably 2 different types of a single disease entity. Pluripotent somatic cell from the Hensen's node and caudal cell mass is the probable origin of spinal teratoma. However, originating from misplaced primordial germ cell could not be excluded.
在英文文献中报道的 170 例椎管内畸胎瘤中，仅有 13 例为脊髓硬膜外畸胎瘤（SET）。我们报告了 1 例 SET，并与脊髓髓内畸胎瘤（SIT）的特点进行了比较，同时探讨了脊髓畸胎瘤的发病机制。
17 个月大的男孩因截瘫就诊于我科。在 T8 至 T10 及左侧椎旁区发现硬膜外多房囊性肿块。通过椎板成形术完成了肿瘤的完全切除，包括椎旁部分。肿瘤包膜完整，内部充满了混杂的内容物。肿瘤被怀疑起源于左侧 T9 神经根。
组织病理学检查发现肿瘤为成熟畸胎瘤。SET 和 SIT 的临床特点在年龄、男性优势、部位、合并畸形和病理方面均表现出相似性。SET 和 SIT 可能是同一疾病实体的 2 种不同类型。来自亨森结和尾侧细胞体的多能体细胞可能是脊髓畸胎瘤的起源，但不能排除起源于错位的原始生殖细胞的可能性。
