Shrestha Aayush, Bijukachhe Binod, Khan Javed Ahmad, Dahal Ram Krishna, Yadav Sandip Kumar
Department of Orthopedics, Grande International Hospital, Kathmandu, Nepal.
Case Rep Orthop. 2022 Jan 25;2022:9365719. doi: 10.1155/2022/9365719. eCollection 2022.
Intradural mature teratomas are spinal tumors containing all the germinal layers and rarely present in adulthood. This study describes an unusual case of intradural mature teratoma in a 19-year-old male who presented with persistent lower limb pain and difficulty in micturition. The magnetic resonance imaging (MRI) scan showed heterogeneously enhancing intramedullary mass in the L3-L4 vertebral region and was associated with tethering of the spinal cord. Scalloping of the posterior aspect of vertebral body and narrowing of the pedicles were present. Subtotal excision of the tumor was done because of its adherence to the conus. Attempt to completely excise such adherent intramedullary tumors can lead to permanent neurological deficits. The tissue was sent for histopathological examination which showed tissue from all the three germinal layers confirming the diagnosis. The patient showed improvement of symptoms following the surgery. This study also compared the literature of similar cases and the treatments available for this disease.
硬脊膜内成熟畸胎瘤是包含所有胚层的脊髓肿瘤，在成年期很少出现。本研究描述了一例罕见的硬脊膜内成熟畸胎瘤病例，患者为一名19岁男性，表现为持续性下肢疼痛和排尿困难。磁共振成像（MRI）扫描显示L3-L4椎体区域髓内肿块不均匀强化，且与脊髓栓系有关。椎体后缘呈扇贝样改变，椎弓根变窄。由于肿瘤与圆锥粘连，故行肿瘤次全切除。试图完全切除这种粘连的髓内肿瘤可能会导致永久性神经功能缺损。组织送去做组织病理学检查，结果显示来自所有三个胚层的组织，从而确诊。患者术后症状有所改善。本研究还比较了类似病例的文献以及针对该疾病的可用治疗方法。
