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Eslami M, Ilaghi M, Shahabinejad E, Khajepour F, Karamouzian S, Reihani‐Kermani H. Mature teratoma of conus medullaris: A case report and review of literature. Clin Case Rep 2023; 11:e7966. [PMID: 37767146 PMCID: PMC10520346 DOI: 10.1002/ccr3.7966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/31/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
In conus medullaris, mature teratomas are rare. We report a case of a 40-year-old man who presented with urinary incontinence, low back pain, and muscle weakness. Magnetic resonance imaging revealed a mass in conus medullaris (T11-L1), further confirmed as a mature teratoma by pathological examination. We identified 63 cases of conus medullaris teratoma over the past two decades by systematically analyzing the case reports. Findings demonstrated that most cases were diagnosed in the fourth decade of life, with the majority of cases (57.6%) being male. Lower back pain, radiating pain in the extremities, hypoesthesia, and urinary dysfunction are the most common clinical presentations among patients with teratoma of conus medullaris. Mature teratoma is the dominant pathologic subtype of teratomas in this region, comprising more than 95% of cases. Our case highlights the importance of considering spinal teratoma as a differential diagnosis in patients presenting with urinary incontinence and lumbar pain.
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Affiliation(s)
- Masoud Eslami
- Department of NeurosurgeryKerman University of Medical SciencesKermanIran
| | - Mehran Ilaghi
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical SciencesKermanIran
| | - Erfan Shahabinejad
- Student Research CommitteeRafsanjan University of Medical SciencesRafsanjanIran
- USERN Office, Rafsanjan University of Medical SciencesRafsanjanIran
| | | | - Saeed Karamouzian
- Department of NeurosurgeryKerman University of Medical SciencesKermanIran
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Uy MNAR, Tantengco OAG. Investigating the landscape and trajectory of spina bifida research in Asia: a bibliometric analysis. Childs Nerv Syst 2022; 38:1581-1591. [PMID: 35474541 DOI: 10.1007/s00381-022-05527-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spina bifida is a type of a neural tube defect which affects 243.14 per 100,000 babies in Asia. Research articles on spina bifida have increased in the recent years. However, no study has focused on the research trends in this field in Asia. METHODS A systematic review of literature on spina bifida in Asia was performed using the Scopus database from inception to 2020. All published studies on spina bifida conducted in or published by authors from Asia were included in our analysis. Bibliometric information was obtained from Scopus and bibliometrics diagrams were created using VOSviewer software. RESULTS A total of 652 articles were obtained in this study. The number of publications showed an upward trend starting 2000s. The country with the greatest number of publications was Japan while All India Institute of Medical Sciences was the most productive institution in spina bifida research in Asia. The current focus of this field in Asia was prevalence of spina bifida, prenatal diagnosis, folic acid supplementation, and complications of spina bifida. Future areas of research in spina bifida include the genetic basis of neural tube defects and the use of stem cell technology as therapies for spina bifida. CONCLUSION This is the first bibliometric analysis on spina bifida in Asia. It showed the trend and future areas of research on spina bifida in Asia. Despite the increase in scientific literature on spina bifida research, more research outputs and collaborations are needed especially in developing countries in Asia.
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Affiliation(s)
| | - Ourlad Alzeus G Tantengco
- College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines.
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Chen Y, Li Z, Chen X, Yin Y, Qiao G. Surgical Treatment Outcomes of Patients with Conus Medullaris Teratoma: A Single-Center Experience of 39 Patients. World Neurosurg 2020; 143:e374-e383. [PMID: 32730968 DOI: 10.1016/j.wneu.2020.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Conus medullaris teratomas are extremely rare, and the treatment experience has been limited. The purpose of the present study was to evaluate the clinical characteristics, radiological features, surgical outcomes, and prognosis of patients with conus medullaris teratoma. METHODS We retrospectively reviewed the data from 39 patients who had undergone surgical resection for conus medullaris teratomas from January 2008 to December 2018. All the operations were performed by 1 senior doctor. The clinical features, pre- and postoperative magnetic resonance imaging findings, pathological features, treatment strategies, and outcomes were analyzed. The neurological status was evaluated using the modified Japanese Orthopaedic Association scale score. RESULTS Of the 39 patients, the mean age was 30.9 years. Of the 39 patients, 20 were male and 19 were female. The symptom duration ranged from 0.3 to 252 months (mean, 61.6 months). Bladder and bowel dysfunction was the most common symptom (76.9%). Total resection was achieved in 25 patients (64.1%), subtotal resection in 11 (28.2%), and partial resection in 3 (7.7%). A mature teratoma was confirmed in all 39 patients. The neurological outcomes were improved 16 patients (45.7%), stable in 14 (40.0%), and aggravated in 5 (14.3%) at a mean follow-up of 62.7 months. Recurrence developed in 1 patient who had undergone subtotal resection. A second surgery with total resection was performed, and the patient's neurological symptoms were stable during follow-up. CONCLUSIONS Total surgical resection is the optimal treatment strategy for patients with conus medullaris teratoma. Safe maximum tumor removal and residual tumor inactivation using electrocoagulation are recommended when total resection cannot be achieved. Surgery can provide a low recurrence rate and an acceptable low complication rate.
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Affiliation(s)
- Yakun Chen
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ze Li
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin Chen
- Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yiheng Yin
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guangyu Qiao
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
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de Oliveira AJM, Guirado VMDP, Yamaki VN, Frasseto FP. Intramedullary teratoma. AUTOPSY AND CASE REPORTS 2019; 9:e2019105. [PMID: 31641653 PMCID: PMC6771445 DOI: 10.4322/acr.2019.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 07/01/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Adilson José Manuel de Oliveira
- Universidade de São Paulo (USP), Faculty of Medicine, Hospital das Clínicas, Department of Neurology. São Paulo, SP, Brazil.,Girassol Clinic, Neurosurgery service, Luanda, Angola
| | | | - Vitor Nagai Yamaki
- Universidade de São Paulo (USP), Faculty of Medicine, Hospital das Clínicas, Department of Neurology. São Paulo, SP, Brazil
| | - Fernando Pereira Frasseto
- Universidade de São Paulo (USP), Hospital das Clínicas, Department of Pathology. São Paulo, SP, Brazil
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A case report of an intramedullary cervical teratoma in an adult patient with cervical spondylotic radiculopathy. Neurocirugia (Astur) 2019; 30:238-242. [DOI: 10.1016/j.neucir.2018.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/31/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022]
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Lipomatous Lumbar Mass with an Attached Digit and Associated Split Cord Malformation. Can J Neurol Sci 2014; 35:250-4. [DOI: 10.1017/s0317167100008738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background:A male infant was born with a digit attached to a skin-covered lumbar lipomatous mass and an underlying split cord malformation.Methods:Surgical removal of the mass was performed at four months-of-age. By this time the digit had grown a nail and imaging and histology showed ongoing development of articulated phalanges.Results:The lipomatous mass contained a long bone, a clavicle-and scapula-like structure and a variety of other mature germ layer derivatives. These features raised a number of diagnostic considerations, including: mature teratoma, hamartoma, rudimentary parasitic twin, lipomyelomeningocele and dorsal accessory limb.Conclusions:Based on review of the literature, the authors hypothesize that there is a pathogenetically related spectrum of skin-covered dorsal mass lesions, often associated with spinal dysraphism. These consist of a major lipomatous component and a variety of mature germ layer derivatives that can vary widely in their degree of anatomical organization from case to case.
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Intramedullary Mature Teratoma of Cervical Spine in an Infant: A Rare Case Report. ROMANIAN NEUROSURGERY 2014. [DOI: 10.2478/romneu-2014-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Spinal Teratomas are rare tumor and cervical intramedullary location in infancy still rarer. Only eleven cases of cervical intramedullary teratoma in pediatric patients is reported in available literature (1, ll). We are reporting a case of an infant presenting with cervical mature teratoma with associated dysraphism, adding the next in this rare case series. Arising as a result of dysembryogenesis, these lesions by virtue of their content are difficult to diagnose preoperatively. Heterogeneous intensities on MRI produced by intralesional lipomatous and osseous elements are helpful but rarely enough to diagnose the tumor. Histology is confirmatory. Mature teratomas generally have good prognosis and a timely intervention can prevent further neurological deterioration. However a strict clinical and radiological follow up is recommended.
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Abstract
At 7 months, an infant born with a third limb attached to a lumbosacral mass with an associated lipomyelomeningocele underwent removal of the limb and spinal cord detethering. Depending on the complexity of the pathology and proximity of the limb to viscera, consultation with neurosurgical and surgical colleagues is recommended.
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Abstract
Spinal dysraphisms in association with accessory limbs are extremely rare congenital anomalies. The potential mechanisms of development and classification of these anomalies remain unclear. We report a unique case of a baby boy with an accessory foot and external genitalia in association with spina bifida.
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Affiliation(s)
- Yona Ringo
- Department of Paediatric Surgery, Oxford Children's Hospital, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
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Chen X, Harter J, Iskandar BJ, Salamat MS. Growing mammary choristoma masquerading as a lumbosacral lipomyelomeningocele in a pubertal girl. J Neurosurg Pediatr 2011; 8:321-4. [PMID: 21882926 DOI: 10.3171/2011.6.peds10480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report, to the best of their knowledge, the first case of lumbosacral choristoma of breast origin, presenting in a young girl with lumbosacral lipomyelomeningocele. Although choristomas are considered to be benign, the regrowth of this mass when the patient was 15 and 16 years of age, and its involvement in the conus medullaris and cauda equina, warranted 2 additional resections with spinal cordotomy resulting in cessation of any further growth. The authors describe the case and provide a review of pertinent literature and a discussion of the mechanisms involving the development and growth of this lesion.
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Affiliation(s)
- Xueyan Chen
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA
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ISHIGURO S, NAGASHIMA T, YAMAMOTO K, KANEKAWA K, YOSHIDA M, KONDOH T. An Infantile Large and Extensive Intramedullary Mature Spinal Teratoma -Case Report-. Neurol Med Chir (Tokyo) 2011; 51:393-6. [DOI: 10.2176/nmc.51.393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jian W, Ying W, Chao Y. Intramedullary spinal teratoma of the conus medullaris: report of two cases. Acta Neurochir (Wien) 2010; 152:553-4. [PMID: 19639248 DOI: 10.1007/s00701-009-0466-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 07/04/2009] [Indexed: 10/20/2022]
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The rare case of an intramedullary cervical spinal cord teratoma in an elderly adult: case report and literature review. Spine (Phila Pa 1976) 2009; 34:E973-8. [PMID: 20010388 DOI: 10.1097/brs.0b013e3181ba0fe5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN.: Case report and literature review. OBJECTIVES.: To report the very rare case of a mature intramedullary teratoma with exophytic extension localized to the uppermost cervical spinal level in a 65-year-old woman and review the pertinent medical literature. SUMMARY OF BACKGROUND DATA.: Cervical intramedullary teratomas are extremely rare in adults, especially in patients older than 50 years. METHODS.: The patient presented with progressive ataxia, mild bilateral kinetic hand tremors, and dizziness. Magnetic resonance imaging revealed an intramedullary 1.7 x 1.3 x 2.3 cm mass at C1 with exophytic extension. A C1-C2 laminectomy and a partial suboccipital craniotomy were performed, followed by a subtotal microscopic resection of the tumor. Pathology was consistent with a mature teratoma. RESULTS.: After surgery, the patient's ataxia, tremor, and dizziness resolved almost immediately. CONCLUSION.: This report presents the very rare case of a mature intramedullary teratoma located in the upper cervical spine of an elderly patient, possibly the oldest patient documented with this type of lesion. The authors recommend a conservative subtotal surgical resection of cervical intramedullary tumors because it may improve symptoms that relate to direct mechanical cord compression and avoid further harm from a gross resection.
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Borlot F, Soares MS, Espíndola AÁD, Reed UC, Matushita H, Teixeira MJ. Intramedullary spinal teratoma: a rare condition with a good outcome. ARQUIVOS DE NEURO-PSIQUIATRIA 2009; 67:733-5. [DOI: 10.1590/s0004-282x2009000400037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ijiri K, Hida K, Yano S, Iwasaki Y. HUGE INTRADURAL OSSIFICATION CAUSED BY A MATURE SPINAL TERATOMA. Neurosurgery 2009; 64:E1200-1; discussion E1201. [PMID: 19487866 DOI: 10.1227/01.neu.0000345939.06275.9a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
Huge intradural ossifications in the spine are quite rare. We report for the first time a patient with a huge intradural ossification caused by a mature teratoma at the conus medullaris.
CLINICAL PRESENTATION
A 68-year-old woman presented with low back pain and gait disturbance. Computed tomographic and magnetic resonance imaging revealed a huge ossification at the tip of the conus medullaris.
INTERVENTION
We performed L1 and L2 laminectomy and removed the mass completely. The pathological diagnosis was mature teratoma with remarkable ossification.
CONCLUSION
This unusual case of intradural ossification demonstrated regressive changes in a mature teratoma. Despite its tight adhesion to the conus medullaris and cauda equina, the ossified tumor was atraumatically removed with an ultrasonic aspirator.
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Affiliation(s)
- Kosei Ijiri
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kazutoshi Hida
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shunsuke Yano
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoshinobu Iwasaki
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Takeyama J, Hayashi T, Saito M, Shimanuki Y, Watanabe M, Sasano H, Shirane R. Spinal hamartoma associated with spinal dysraphism. Childs Nerv Syst 2006; 22:1098-102. [PMID: 16328392 DOI: 10.1007/s00381-005-0016-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Indexed: 10/25/2022]
Abstract
OBJECTS The aims of the study were (1) to review the pathological findings of spinal lipomatous masses associated with congenital spinal dysraphism and (2) to discuss the pathological diagnosis. METHODS The pathological records of 47 patients at our institution were reviewed, and three illustrative cases were presented. CONCLUSION Spinal tumorous lesions associated with spinal dysraphism have been traditionally described as lipoma since they are composed mostly of fatty tissue. However, they are different from lipomas arising in other part of the body in that they often contain various tissues of ecto- and mesodermal origin. In our study, we detected such heterotopic components in 24 out of 47 cases. Although they are also similar to teratoma, it is generally accepted that they are malformative lesions which lack neoplastic potential. We therefore should diagnose them as hamartoma rather than lipoma or teratoma.
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Affiliation(s)
- Junji Takeyama
- Department of Pathology, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai 989-3126, Japan.
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Vaishya S, Pandey P. Unusual spinal teratoma with an accessory penis on the back. Childs Nerv Syst 2006; 22:440-3. [PMID: 16267680 DOI: 10.1007/s00381-005-1241-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2004] [Revised: 01/17/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Spinal teratomas are extremely rare tumours, and their association with split cord malformation is even rarer. CASE REPORT This is a case report of an infant with a large teratoma with a lipomyelomeningocele along with a split cord malformation and with an unusual accessory penis and scrotum on the back over the swelling. This, to our knowledge, is the first such case reported in the English literature.
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Affiliation(s)
- Sandeep Vaishya
- Department of Neurosurgery, C.N. Center, All India Institute of Medical Sciences, Ansari Nagar, 110029 New Delhi, India.
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Tsitsopoulos P, Rizos C, Isaakidis D, Liapi G, Zymaris S. Coexistence of spinal intramedullary teratoma and diastematomyelia in an adult. Spinal Cord 2006; 44:632-5. [PMID: 16389271 DOI: 10.1038/sj.sc.3101886] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A case report of intramedullary spinal cord teratoma with remote diastematomyelia in a female adult. OBJECTIVE To present a rare case of a dysembryogenic spinal tumor with concurrent split cord malformation and to define the importance of early surgical removal of the tumor. SETTING A department of neurosurgery in Greece. METHODS A 44-year old woman, presented with progressive lower limb muscle weakness, gait disturbances and dysesthesias in the trunk and lower extremity. She underwent plain radiographs, CT and MRI scan, which revealed an exophytic intramedullary spinal cord tumor at the level of T8-T10 and distant diastematomyelia in the upper lumbar spine (L2-L3). She underwent surgical intervention. The tumor was subtotally removed. No attempt was made to treat diastematomyelia. RESULTS Postoperatively, the patient's neurological status started to improve gradually. After 1 year she exhibited better strength in the lower limb muscles and improved sensation. The histological examination demonstrated mature spinal teratoma consisting of ectodermal, mesodermal and endodermal elements. CONCLUSIONS In adult patients with intramedullary masses of possible dysembryogenic origin, the whole spine must be examined for additional dysraphic lesions. The choice and the timing of a surgical intervention are strongly dependent on the clinical picture.
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Affiliation(s)
- P Tsitsopoulos
- Department of Neurosurgery, Thriassio General Hospital, Elefsina, Greece
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Ates O, Cayli SR, Koçak A, Alkan A, Onal C, Usta U. Mature spinal teratoma associated with thickened filum terminale. Neurol Med Chir (Tokyo) 2005; 45:375-8. [PMID: 16041186 DOI: 10.2176/nmc.45.375] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 30-year-old man presented with an intradural spinal teratoma with thickened filum terminale manifesting as urinary and sexual disturbances, and low back pain persisting for 4 years. Spinal magnetic resonance imaging revealed thickened filum terminale containing a heterogeneously enhanced intradural lesion extending from the L-3 to L-4 levels and in contact with the conus medullaris. The filum terminale was incised and the tumor was totally resected. The histological diagnosis was mature teratoma consisting of three germ cell layers. The patient's complaints had completely resolved 6 months later.
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Affiliation(s)
- Ozkan Ates
- Department of Neurosurgery, Inönü University School of Medicine.
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Wagner W, Koch D. Spinal rhabdomyosarcoma in a child with lipomyelomeningocele. Pediatr Neurosurg 2004; 40:293-6. [PMID: 15821360 DOI: 10.1159/000083742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2004] [Accepted: 08/16/2004] [Indexed: 11/19/2022]
Abstract
Malignant tumors arising within dysrhaphic malformations are very rare and are mostly teratomas; so far, only one rhabdomyosarcoma has been reported in this context. We report another case of a girl with lipomyelomeningocele who developed a lumbar rhabdomyosarcoma 2 years after birth and primary closure of the neural tube defect. We present clinical, radiological and pathological findings, discuss possible mechanisms of malignant transformation and review the literature.
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Affiliation(s)
- Wolfgang Wagner
- Department of Neurosurgery, Section of Pediatric Neurosurgery, University Hospitals, Mainz, Germany.
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