Acute regrowth and dissemination of a mature spinal cord teratoma after partial resection.
Momotaro KawaiNarihito NagoshiAkio IwanamiShuji MikamiOsahiko TsujiNobuyuki FujitaMitsuru YagiKota WatanabeKen IshiiMasaya NakamuraMorio MatsumotoPublished in: BMJ case reports (2018)
A 23-year-old man presented with difficulty walking and leg pain and numbness. MRI revealed a cystic mass at Th11-12 and a pineal-region tumour. The patient underwent surgery to resect the thoracic-level mass. The tumour adhered strongly to the neural tissue and could only be partially resected. On pathological examination, the resected tumour was diagnosed as a mature teratoma. The tumour regrew and disseminated within 3 months after resection. Both the spinal cord tumour and the tumour in the pineal region shrank significantly after chemotherapy and radiotherapy. Although the tumour was pathologically diagnosed as a mature teratoma, we suspect that the residual tumour contained an immature or malignant component. Thus, careful follow-up observation is mandatory after partial resection of a mature teratoma. In addition, because teratomas can disseminate in the central nervous system, the presence of teratoma should prompt an examination of both the spinal cord and brain.
Keyphrases
- spinal cord
- neuropathic pain
- magnetic resonance imaging
- multiple sclerosis
- chronic pain
- early stage
- magnetic resonance
- squamous cell carcinoma
- acute coronary syndrome
- locally advanced
- functional connectivity
- resting state
- respiratory failure
- rectal cancer
- white matter
- blood brain barrier
- coronary artery bypass
- lower limb
- subarachnoid hemorrhage
- diffusion weighted imaging