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Intramedullary immature teratoma in a young infant involving a long segment of the spinal cord
1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Insights
A rare intramedullary immature teratoma was found in a 3-month-old infant, extending over a large spinal cord area. Complete surgical removal led to significant neurological recovery, highlighting early diagnosis and intervention for holocord tumors.
Area of Science:
- Pediatric Neurosurgery
- Spinal Cord Oncology
- Developmental Pathology
Background:
- Intramedullary teratomas are rare spinal cord tumors, typically found in the lumbosacral region.
- Extensive holocord intramedullary teratomas in young infants are exceptionally uncommon.
Observation:
- A 3-month-old infant presented with paraplegia and sphincter disturbances.
- Spinal MRI revealed a large, heterogeneously enhancing intramedullary lesion from C-5 to T-12.
- Histological examination of the tumor biopsy confirmed mature intestinal tissue, indicative of teratoma.
Findings:
- The immature teratoma was surgically excised completely.
- Post-operative improvement in paraplegia and sphincter function was observed.
- Neurological recovery was possible despite a 1-month history of paraplegia.
Implications:
- Intramedullary teratoma must be considered in the differential diagnosis of holocord tumors in infants with rapid neurological decline.
- Radical surgical excision is the recommended treatment for intramedullary teratomas.
- Early histological diagnosis and prompt surgical intervention can lead to favorable neurological outcomes, even in severe cases.
Abstract:
Intramedullary teratoma is a rare lesion, located in the majority of cases in the lumbosacral area, and such lesions involving an extensive area of the spinal cord in young infants have seldom been reported. We present the case of a 3-month-old girl with an intramedullary spinal immature teratoma extending from C-5 to T-12, which was totally removed. The patient had suffered from paraplegia for 15 days, after which spinal MRI revealed a heterogeneously enhancing intramedullary lesion. Biopsy of the lesion demonstrated mature intestinal tissue. After total removal of the tumor, paraplegia and sphincter disturbances improved. Intramedullary teratoma should be included in the differential diagnosis of holocord tumors in young infants with rapidly progressing symptoms and if found should be radically excised. This case also emphasizes the importance of histological diagnosis and demonstrates the possibility of neurological recovery even in the case of paraplegia lasting for more than 1 month in a young infant.
