Mohammadi Alireza, Fereydouni Taha, Rahbari Ali, Mokarian Peyman, Khademi Zoha
Department of Neurosurgery, Valiasr Hospital, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.
World Neurosurg. 2017 Oct;106:1051.e5-1051.e8. doi: 10.1016/j.wneu.2017.06.175. Epub 2017 Jul 11.
Intradural teratomas are an exceedingly unusual phenomenon. They are tumors with the cellular constituent source of all the 3 germ cell layers.
We here report a case of an 18-year-old man with special pathologic features. There was no history of spinal dysraphism, congenital spinal abnormalities, previous spinal surgery, or lumbar puncture. Lumbosacral spine magnetic resonance imaging revealed a well-delineated, intramedullary mass at the L2-3 level. Histopathology examination of the resected tumor revealed cystic spaces lined with simple columnar epithelium as well as mucus secreting epithelium, adipose tissue, salivary gland-like serous cells, and bundles of smooth muscle cells. We have seen unusual histopathologic features in the case, for example, there were no cartilage components that are mostly found in mature teratomas, abundant Pacinian corpuscle nerve endings, and nerve trunks. There were no immature elements or malignant cells.
Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions, even after the imaging reveals tissue homogeneity.
硬脊膜内畸胎瘤是一种极为罕见的现象。它们是具有所有三个胚层细胞组成来源的肿瘤。
我们在此报告一例具有特殊病理特征的18岁男性病例。患者无脊柱裂、先天性脊柱异常、既往脊柱手术或腰椎穿刺史。腰骶部脊柱磁共振成像显示L2 - 3水平有一个边界清晰的髓内肿块。对切除肿瘤的组织病理学检查显示,囊肿腔内衬有单层柱状上皮以及黏液分泌上皮、脂肪组织、唾液腺样浆液细胞和平滑肌细胞束。我们在该病例中看到了不寻常的组织病理学特征,例如,成熟畸胎瘤中常见的软骨成分缺失、丰富的环层小体神经末梢和神经干。未发现不成熟成分或恶性细胞。
即使影像学显示组织均匀性,在髓内病变的鉴别诊断中也应考虑畸胎瘤。