title: The rare case of an intramedullary cervical spinal cord teratoma in an elderly adult: case report and literature review.
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.
authors.affiliation: Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, CA, USA. sghostine@hotmail.com
authors.forename: Samer
authors.initials: S
authors.lastname: Ghostine
authors.forename: Edward
authors.initials: E
authors.lastname: Perry
authors.forename: Shoshanna
authors.initials: S
authors.lastname: Vaynman
authors.forename: Ravi
authors.initials: R
authors.lastname: Raghavan
authors.forename: Karen A
authors.initials: KA
authors.lastname: Tong
authors.forename: Srinath
authors.initials: S
authors.lastname: Samudrala
authors.forename: J Patrick
authors.initials: JP
authors.lastname: Johnson
authors.forename: Austin
authors.initials: A
authors.lastname: Colohan
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D013120:Spinal Cord Neoplasms / Q000473:pathology* / Q000601:surgery; D013724:Teratoma / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome