Journal of Clinical Orthopaedics | Vol 5 | Issue 2 | July-Dec 2020 | page:49-52 | Sapan Kumar, Sanjeev kumar, Mohit Kumar Patralekh, Ramesh Kumar
Author: Sapan Kumar , Sanjeev kumar , Mohit Kumar Patralekh , Ramesh Kumar 
 Department of Orthopaedics, VMMC & Safdarjung Hospital, Delhi-110029, India
Address of Correspondence
Dr. Sapan Kumar,
Department of Orthopaedics, VMMC & Safdarjung Hospital, Delhi-110029, India
Background: Teratoma is a germ cell tumour that is composed of a variety of parenchymal cell types derived from all three germinal layers (ectoderm, mesoderm, and endoderm). Spinal teratomas are very rare. Only 0.15-0.18% of spinal tumours have been classified as teratomas. We report two cases of spinal cord teratoma managed surgically, with good outcome.
Case reports: A 23 year old female presented with back pain and right lower limb weakness. She was evaluated by blood and radiological investigation. T12 through L2-3 flip laminoplasty with fixation was performed and the tumour was totally removed. The postoperative course was excellent, and histopathologically, numerous fatty cysts consisting of neuroepithelial and epithelial tissues were observed. The final diagnosis was that of a mature cystic teratoma.
Another 22 year old male, was presented with back pain for six months. He was evaluated by blood and radiological investigation. Total resection of the tumour by means of L2 – L3 laminectomy was done. Ectodermal, mesodermal and endodermal
elements were revealed. The final histopathological diagnosis was that of a mature cystic teratoma.
Conclusion: Although intramedullary teratomas are very rare in adults, they need to be considered in differential diagnosis. The present study also compares the literature
concerning adult intradural mature teratoma, summarises the basic clinical characteristics and theory of origin of adult intradural mature teratoma and reviews the available treatment options for this disease.
Key words: Intradural; Intramedullary; Spinal Cord; Teratoma; Adult.
1. Virchow R. Die Krankhaften Geschwulste. 1863; vol 1. pp 514
2. Gowers WR, Horsley V. A case of tumour of the spinal cord. Removal; recovery. Medico-chirurgical transactions. 1888;71:377-430.
3. Sharma MC, Jain D, Sarkar C, Suri V, Garg A, Singh M, Mahapatra AK, Sharma BS. Spinal teratomas: a clinico-pathological study of 27 patients. Acta neurochirurgica. 2009 Mar 1;151(3):245-52.
4. Li Y, Yang B, Song L, Yan D. Mature teratoma of the spinal cord in adults: An unusual case. Oncology letters. 2013 Oct 1;6(4):942-6.
5. Elmacı İ, Dağçinar A, Özgen S, Ekinci G, Pamir MN. Diastematomyelia and spinal teratoma in an adult: case report. Neurosurgical focus. 2001 Jan 1;10(1):1-4.
6. Rasmussen TB, Kernohan JW, Adson AW. Pathologic classification, with surgical consideration, of intraspinal tumours. Annals of surgery. 1940 Apr;111(4):513-30.
7. Smoker WR, Biller J, Moore SA, Beck DW, Hart MN. Intradural spinal teratoma: case report and review of the literature. American journal of neuroradiology. 1986 Sep 1;7(5):905-10.
8. Garrison JE, Kasdon DL. Intramedullary spinal teratoma: case report and review of the literature. Neurosurgery. 1980 Nov 1;7(5):509-12.
9. Chandler CL, Uttley D, Wilkins PR, Kavanagh TG. Primary spinal malignant schwannoma. British journal of neurosurgery. 1994 Jan 1;8(3):341-5.
10. Koen JL, McLendon RE, George TM. Intradural spinal teratoma: evidence for a dysembryogenic origin: report of four cases. J Neurosurg. 1998;89:844–51.
11. Vanguardia MK, Honeybul S, Robbins P. Subtotal resection of an intradural mature teratoma in an adult presenting with difficulty initiating micturition. Surg Neurol Int. 2014;5.
12. Koen JL, McLendon RE, George TM. Intradural spinal teratoma: evidence for a dysembryogenic origin. Report of four cases. J Neurosurg 1998;89:844-51.
13. Rewcastle NB, Francoeur J. Teratomatous cysts of the spinal canal; with “sex chromatin” studies. Arch Neurol 1964;11:91-9.
14. Bucy PC, Buchanan DN. Teratoma of the spinal cord. Surg Gynecol Obstet 1935; 60:1137 – 44.
15. Cybulski GR, vonRoenn KA, Bailey OT. Intramedullary cystic teratoid tumour of the cervical spinal cord in association with a teratoma of the ovary. Surg Neurol 1984; 22:267 – 72.
16. Hosoi K. Intradural teratoid tumours of the spinal cord. Arch Pathol 1931; 11: 875-83.
17. Ingaham FD, Bailey OT. Cystic teratomas and teratoid tumours of the central nervous system in infancy and childhood. J Neurosurg 1946; 3: 511 – 32.
18. Matson DD. Neurosurgery of Infancy and Childhood, ed 2. Spring®eld, CC Thomas 1969; pp 647 – 88.
19. Nakayama K. Spinal teratoma (Report of an elderly case). Neurol Med Chir (Tokyo) 1983; 23: 963 – 967.
20. Poeze M, Herpers MJ, Tjandra B, Freling G, Beuls EA. Intramedullary spinal teratoma presenting with urinary retention: case report and review of the literature. Neurosurgery 1999;45:379-85.
21. Rosenbaum TJ. Teratomatous cyst of the spinal canal: Case report. J Neurosurg 1978;49: 292 – 97.
22. Ak H, Ulu MO, Sar M, Albayram S, Aydin S and Uzan M: Adult intramedullary mature teratoma of the spinal cord: review of the literature illustrated with an unusual example. Acta Neurochir (Wien) 2006; 148: 663-9.
23. Allsopp G, Sgouros S, Barber P and Walsh AR: Spinal teratoma: is there a place for adjuvant treatment? Two cases and a review of the literature. Br J Neurosurg. 2000; 14: 482-8.
|How to Cite this article: Kumar S, kumar S, Patralekh MK, Kumar R. Mature Spinal Cord Teratoma In Adults: Report Of Two Unusual Cases And Literature Review. Journal of Clinical Orthopaedics July-Dec 2020;5(2):49-52.|