Acharya Ashish, Grewal Sarvpreet Singh, Sobti Shivender, John Paul Sudhakar, Bind Ravindra Kumar, Bhardwaj Maneesh Kumar, Mathews Shefin J
Department of Neurosurgery, Christian Medical College.
Department of Neurosurgery, Dayanand Medical College, Ludhiana, Punjab, India.
Surg Neurol Int. 2020 Aug 29;11:266. doi: 10.25259/SNI_442_2020. eCollection 2020.
Spinal teratomas are rare in adults. The clinical findings are nonspecific, reflecting only in the intramedullary location of these lesions. The potential differential diagnosis for intramedullary spinal teratomas include schwannomas, dermoids, epidermoids, and neurofibromas.
A 25-year-old male presented with RLE weakness (iliopsoas/quadriceps [4/5], and extensor hallucis longus/dorsiflexor [0/5]) and urinary incontinence. As the contrast, MR showed a heterogeneous intramedullary lesion with well-defined edges located at the T12-L1 level, the patient underwent a focal laminectomy for gross total tumor excision. Pathologically, it proved to be a mature teratoma.
Teratomas should be considered among the differential diagnostic considerations for intramedullary spinal cord lesions. Although gross total resection is preferred, these lesions have a low recurrence rate, and therefore, partial removal is also valid, where lesions are densely adherent to adjacent neural structures.
脊髓畸胎瘤在成人中罕见。临床表现无特异性,仅反映这些病变位于髓内。髓内脊髓畸胎瘤的潜在鉴别诊断包括神经鞘瘤、皮样囊肿、表皮样囊肿和神经纤维瘤。
一名25岁男性出现右下肢无力(髂腰肌/股四头肌[4/5],拇长伸肌/背屈肌[0/5])和尿失禁。磁共振成像(MR)显示在T12-L1水平有一个边界清晰的异质性髓内病变,该患者接受了局部椎板切除术以进行肿瘤全切。病理检查证实为成熟畸胎瘤。
畸胎瘤应列入髓内脊髓病变的鉴别诊断考虑范围。虽然首选肿瘤全切,但这些病变复发率低,因此,当病变与相邻神经结构紧密粘连时,部分切除也是可行的。