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Intradural Intramedullary Teratoma Presenting in the Lumbar Spine: Report of a Rare Case.

World Neurosurgery 2017 October
BACKGROUND: Intradural teratomas are an exceedingly unusual phenomenon. They are tumors with the cellular constituent source of all the 3 germ cell layers.

CASE DESCRIPTION: We here report a case of an 18-year-old man with special pathologic features. There was no history of spinal dysraphism, congenital spinal abnormalities, previous spinal surgery, or lumbar puncture. Lumbosacral spine magnetic resonance imaging revealed a well-delineated, intramedullary mass at the L2-3 level. Histopathology examination of the resected tumor revealed cystic spaces lined with simple columnar epithelium as well as mucus secreting epithelium, adipose tissue, salivary gland-like serous cells, and bundles of smooth muscle cells. We have seen unusual histopathologic features in the case, for example, there were no cartilage components that are mostly found in mature teratomas, abundant Pacinian corpuscle nerve endings, and nerve trunks. There were no immature elements or malignant cells.

CONCLUSIONS: Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions, even after the imaging reveals tissue homogeneity.

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