Extramedullary spinal teratoma presenting with recurrent aseptic meningitis.
BACKGROUND
Spinal teratomas are extremely rare; they constitute <0.5% of all spinal cord tumors. These rare tumors have nonspecific manifestations but in most cases are accompanied by neurological deficits. Rupture of a mature teratoma can cause chemical meningitis.


METHODS
A 7-year-old boy presented with paroxysmal abdominal pain and a history of recurrent aseptic meningitis. Kernig and Brudzinski signs were present. Lumber puncture revealed pleocytosis with no evidence of bacteria growth. Imaging of the spine revealed a cystic lesion in spinal cord at thoracic level 9-11. Endoscopic excision of the cyst was successfully performed. Surgical and histopathological findings confirmed extramedullary matured teratoma.


CONCLUSIONS
As the symptomatic attacks of spontaneous rupture of spinal teratoma resemble presentations of Mollaret meningitis, spinal teratoma should be considered in the differential diagnosis of Mollaret meningitis. We describe a rare example of spinal teratoma causing recurrent meningitis. Spine imaging should be considered in individuals with recurrent aseptic meningitis as this promotes earlier diagnosis, more appropriate treatment, and improved neurological outcome.
Department of Pediatrics, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
Lucy L
LL
Mpayo
Department of Pediatrics, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China. Electronic address: liuxiaoh@mail.xjtu.edu.cn.
Xiao-Hong
XH
Liu
Department of Pediatrics, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
Man
M
Xu
Department of Pathology, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
Kai
K
Wang
Department of Pediatrics, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
Jiao
J
Wang
Department of Pediatrics, The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
Li
L
Yang
D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000503:physiopathology*; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D013724:Teratoma / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome
Mollaret meningitis; aseptic meningitis; spinal tumor; teratoma