title: Adult Intramedullary Teratoma of the Spinal Cord: A Case Report and Review of Literature.
abstract: BACKGROUND
  Teratomas of the spinal cord constitute 0.1% of all spinal tumors, and these lesions are extremely rare in adults. The authors describe a rare case of intradural intramedullary teratoma of the conus medullaris and perform review of literature of intramedullary teratomas seen in the thoracolumbar region.
  
  
  METHODS
  A 48-year-old man presented with fasciculations in the bilateral upper and lower extremities. Radiologic findings revealed an L2-L3 level intradural, nonenhancing, extramedullary cystic mass measuring 15 × 13 mm with a 6-mm enhancing nodule at the level of the conus medullaris. The patient was followed up for 1 year, during which time enlargement of the lesion with new areas of patchy contrast enhancement were observed. L1-L2 decompressive laminectomies were performed, and gross total resection of the lesion was achieved. Histopathologic examination confirmed the diagnosis of benign mature cystic teratoma. A literature review revealed no incidence difference in intramedullary teratomas between males and females (P > 0.05). The mean age at the time of diagnosis was 36.4 ± 12.3 years for men and 41.3 ± 11.6 for women (P < 0.05). The mean symptom duration before treatment was 64.6 ± 79.4 months for females and 20.7 ± 13.8 months for men (P < 0.05). Complete resection was achieved in 48.1% of the cases.
  
  
  CONCLUSIONS
  Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions when the imaging reveals variable signal intensity because of tissue heterogeneity. A partial resection is a viable treatment option when the lesion is attached to vital structures because of the low recurrence rates reported in the literature.
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Nefize
authors.initials: N
authors.lastname: Turan
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Sameer H
authors.initials: SH
authors.lastname: Halani
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Griffin R
authors.initials: GR
authors.lastname: Baum
authors.affiliation: Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Stewart G
authors.initials: SG
authors.lastname: Neill
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: Constantinos.Hadjipanayis@mountsinai.org.
authors.forename: Constantinos G
authors.initials: CG
authors.lastname: Hadjipanayis
mesh_terms: D019299:Decompression, Surgical; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D013724:Teratoma / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Intramedullary; Mature teratoma; Spinal cord neoplasm