Xi Zhiyu, Lu Songsong
Neurological Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Anhui, CHN.
Neurological Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Hefei, CHN.
Cureus. 2024 Aug 23;16(8):e67634. doi: 10.7759/cureus.67634. eCollection 2024 Aug.
Intracranial teratoma, a subtype of non-germinomatous germ cell tumors, is rare in adults. Clinical presentation of intracranial teratomas varies according to where they grow. In particular, cases of spontaneous ruptures of intracranial teratoma are sporadic. This study reports the case of an adult with a spontaneously ruptured mature teratoma in the cerebellar vermis, which was comorbid with a dermal sinus tract and subcutaneous lipoma. Before surgery, because the images were atypical of a teratoma, the patient was misdiagnosed as having vascular malformation rupture and bleeding in the cerebellar vermis. Due to the patient's level of consciousness dropping drastically to a coma, a craniotomy was performed. During the surgery, the tumor was observed to be a mixed cystic and solid mass. The liquid in the cyst was dark green and with a fatty component. The solid part had a tough texture and comprised hair, fat, cartilage, and calcification components. Post-surgery multipoint biopsy proved that it was a mature teratoma and that it was connected to a subcutaneous lipoma through the dermal sinus tract across the occipital bone. After proactive treatment, the patient's prognosis was favorable.
颅内畸胎瘤是非生殖细胞瘤性生殖细胞肿瘤的一种亚型，在成人中较为罕见。颅内畸胎瘤的临床表现因生长部位而异。特别是，颅内畸胎瘤自发破裂的病例较为散在。本研究报告了一例成人患者，其小脑蚓部成熟畸胎瘤自发破裂，并合并皮样窦道和皮下脂肪瘤。术前，由于影像学表现不典型，该患者被误诊为小脑蚓部血管畸形破裂出血。由于患者意识水平急剧下降至昏迷，遂行开颅手术。术中观察到肿瘤为囊实性混合肿块。囊内液体呈深绿色，含有脂肪成分。实性部分质地坚韧，包含毛发、脂肪、软骨和钙化成分。术后多点活检证实为成熟畸胎瘤，且通过枕骨处的皮样窦道与皮下脂肪瘤相连。经过积极治疗，患者预后良好。
