Sertbaş İdris, Karatay Mete
Deparment of Neurosurgery, Yeni yüzyıl Univercity Medical of School, çukurçeşme caddesi no:51 Gaziosmanpaşa, İstanbul, Turkey.
Childs Nerv Syst. 2019 Feb;35(2):369-372. doi: 10.1007/s00381-018-3956-x. Epub 2018 Aug 29.
Teratomas are derived from all three germ layers and make up 3% of all childhood tumors. They are histologically classified as mature or immature. We present a case that was operated on when 30 days old for a sacrococcygeal mature teratoma and then showed long segment involvement in the thoracolumbar region 9 months after the surgery. The MRI (magnetic resonance imaging) showed a mass starting at the thoracal 4 level and extending to the lumbar 3 level with significant spinal cord compression in the extradural space.
The laminae between thoracal 4 and lumbar 3 levels were removed en bloc at a single surgical session and laminoplasty was performed after tumor resection. We also removed the tumor growing into the extrapleural space at the thoracal 5, 6, and 9, 10, 11, 12 levels using the costotransversectomy procedure.
We emphasize with this case that mature teratomas can show aggressive growth following surgery and that the development of spinal deformities can be prevented with laminoplasty.
畸胎瘤起源于所有三个胚层,占儿童肿瘤的3%。它们在组织学上分为成熟型或未成熟型。我们报告一例30天大时因骶尾部成熟畸胎瘤接受手术,术后9个月出现胸腰段长节段受累的病例。磁共振成像(MRI)显示一个肿块从胸4水平开始,延伸至腰3水平,硬膜外间隙有明显脊髓受压。
在一次手术中整块切除胸4至腰3水平的椎板,并在肿瘤切除后进行椎板成形术。我们还采用肋骨横突切除术切除了在胸5、6和9、10、11、12水平长入胸膜外间隙的肿瘤。
我们通过这个病例强调,成熟畸胎瘤术后可出现侵袭性生长,椎板成形术可预防脊柱畸形的发生。