Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, Av. Batallon de San Patricio 112, Real San Agustín, 66,260 San Pedro Garza García, Nuevo León, Mexico.
Childs Nerv Syst. 2024 Apr;40(4):1011-1017. doi: 10.1007/s00381-024-06317-8. Epub 2024 Mar 2.
Spinal teratomas are infrequent lesions in the pediatric population. These lesions can be extradural, intradural or intramedullary. We present a case of an 8-month-old boy that was assessed for underdevelopment of motor milestones. The neurologic examination revealed hyporeflexia, decreased sensation and flaccid paraplegia. MRI of the spine revealed two simultaneous and independent lesions in the extradural and intradural compartment. A laminectomy was performed for the T4-T7 vertebrae with total resection of both lesions. The histopathological analysis confirmed both lesions to be mature cystic teratomas. At the 1-year follow-up, the patient remained with no recovery of neurological function. A debate takes place regarding the etiology of formation of these lesions in the spine. The simultaneous presentation of two independent lesions in this patient could contribute to define the flawed migration of germ cells theory as the etiology for formation of teratomatous lesions in the spine.
椎管内畸胎瘤在儿科人群中较为少见。这些病变可位于硬膜外、硬膜内或脊髓内。我们报告了一例 8 个月大的男婴,因运动发育里程碑延迟而就诊。神经系统检查显示反射减弱、感觉减退和弛缓性截瘫。脊柱 MRI 显示 T4-T7 椎骨的硬膜外和硬膜内同时存在两个独立的病变。对 T4-T7 椎骨进行椎板切除术,完全切除两个病变。组织病理学分析证实两个病变均为成熟囊性畸胎瘤。在 1 年的随访中,患者的神经功能没有恢复。关于这些脊柱病变的形成病因存在争议。本例中两个独立病变的同时出现可能有助于确定生殖细胞迁移缺陷理论是脊柱畸胎瘤形成的病因。