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The Rare Case of an Intramedullary Cervical Spinal Cord Teratoma in an Elderly Adult

2009; Lippincott Williams & Wilkins; Volume: 34; Issue: 26 Linguagem: Inglês

10.1097/brs.0b013e3181ba0fe5

1528-1159

Samer Ghostine, Edward C. Perry, Shoshanna Vaynman, Ravi Raghavan, Karen A. Tong, Srinath Samudrala, J. Patrick Johnson, Austin R. T. Colohan,

Cerebrospinal fluid and hydrocephalus

In Brief 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 × 1.3 × 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. We present the extremely rare case of a mature intramedullary teratoma at C1 with exophytic extension in a 65-year-old woman, possibly the oldest patient with such a lesion. The patient presented with ataxia, hand tremors, and dizziness. A conservative subtotal surgical resection achieved successful decompression to resolve symptoms while minimizing iatrogenic injury.