Intramedullary teratoma of the spine: report of two adult cases.

STUDY DESIGN: Two case reports of intramedullary teratoma in the spinal cord of adults, and a review of the literature.

OBJECTIVE: To investigate and describe unusual cases of spinal teratoma using MRI to define features that may be used to avoid misdiagnosis.

SETTING: A department of orthopedic surgery in Japan.

METHODS: One patient, a 37-year-old woman, was referred because of gait disturbance. She was evaluated by myelography, CT scan with myelography, and MRI. T12 through L1 laminoplasty was performed and the tumor was subtotally removed. The other patient, a 56-year-old man, was referred because of muscle weakness and sensory disturbance. MRI revealed multiple spinal tumors. C4 through C6 laminoplasty and T12 through L2 laminoplasty were performed, and the tumors in these regions were subtotally removed.

RESULTS: In Case 1, the postoperative course was excellent, and histological examination of the resected specimen revealed a spinal teratoma consisting of ectodermal and mesodermal elements. In Case 2, the symptoms were resolved after surgery, and ectodermal, mesodermal and endodermal elements were revealed.

CONCLUSIONS: Although intramedullary teratomas are very rare in adults, they need to be considered in differential diagnosis.