Intradural extension of a sacrococcygeal teratoma.
Intradural extension of a sacrococcygeal teratoma (SCT) is extremely rare and only well-documented in presacral tumors that have been associated with a familial history, anorectal stenosis, and sacral dysraphism. This case documents the extension of a type I SCT into the dural sac with attachment to the filum terminale. A full-term female was transferred to our tertiary newborn intensive care unit with a sacral mass measuring 12 x 13 cm. It protruded from the buttocks and displaced the anus anteriorly. Rectal examination showed no presacral component. Radiographs demonstrated calcification in the soft tissue mass and a normal-appearing sacrum with the last sacral segment not visualized. At operation during dissection of the cephalad component, the SCT extended into the spinal canal. Neurosurgical consultation resulted in a sacral laminectomy which revealed the tumor to be attached to the tip of the filum terminale. The tumor was removed in toto with all sacral roots preserved. The infant required a second operation to revise a wound dehiscence and suspected cerebrospinal fluid leak. The final pathology report was benign SCT. Follow-up at 2 years showed no recurrence, normal sphincter tone, and a normal computed tomography scan. This represents the first well-documented intradural extension of a Type I SCT with attachment to the spinal cord. This extremely rare occurrence requires awareness with the availability of neurosurgical support to expedite operative management.
Powell
R W
RW
Department of Surgery, University of South Alabama College of Medicine, Mobile.
Weber
E D
ED
Manci
E A
EA
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D012445:Sacrococcygeal Region; D013115:Spinal Canal; D013120:Spinal Cord Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D013724:Teratoma / Q000151:congenital* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery