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Table 1: Adult intradural spinal mature teratoma cases previously reported in the literature
Author, year Age Male/female Spinal level Associated dysraphism Extent of surgery
Kubie and Fulton, 1928 27 Female C3-C4 No Incomplete
[2]
Hosoi, 1931 24 Male L2-L3 L5-S1 spina bifi da Incomplete
[3]
[4]
Sullivan, 1948 32 Female L1-L3 No Complete
[5]
Bakay, 1956 65 Female L1-L2 L1 and L2 vertebral body Incomplete
[6]
Sloof et al., 1964 20 Male L1 No Complete
[7]
Rewcastle and Francoeur, 1964 34 Female T10 No Incomplete
Hansebout and Bertrand, 1965 47 Male L1-L3 No Complete
[8]
Eneström and Von Essen, 1977 36 Male T11-L1 No Incomplete
[9]
[10]
Rosenbaum et al., 1978 49 Male T9 No Complete
[11]
Garrison and Kasdon, 1980 23 Male L2 No Complete
Padovani et al., 1983 33 Female T12-L1 No Complete
[12]
Pelissou-Guyotat et al., 1988 33 Male L4 L4 spina bifi da occulta Complete
[13]
[14]
Nicoletti et al., 1994 47 Male Conus medullaris Conus medullaris caudal exophy Incomplete
Caruso et al., 1996 41 Male Conus medullaris No Complete
[15]
al-Sarraj et al., 1998 35 Male Conus medullaris No Incomplete
[16]
[17]
Poeze et al., 1999 23 Male T12-L1 No Incomplete
[18]
Fan et al., 2001 43 Female L2 No Complete
[19]
Nonomura et al., 2002 37 Female T12-L1 No Incomplete
56 Male T12-L2 No Incomplete
Hejazi and Witzmann, 2003 45 Female T11-L3 No Complete
[20]
20 Male L2-L4 No Complete
Fernández-Cornejo et al., 2004 43 Male L1-L2 No Complete
[1]
Ak et al., 2006 43 Female C2-C3 C3 spinal bifi da, C5 level nodule Complete
[21]
[22]
Makary et al., 2007 46 Female C1-C2 C1-C2 dysraphic congenital Complete
spinal malformations
Biswas et al., 2009 28 Male L2-L4 No Complete
[23]
Ghostine et al., 2009 65 Female C1-C2 No Incomplete
[24]
Ijiri et al., 2009 68 Female L1-L2 No Complete
[25]
Jian et al., [26] 2010 57 Male Conus medullaris No Complete
Musil et al., 2011 60 Female Conus medullaris No Incomplete
[27]
Li et al., 2013 23 Female T12-L2 No Complete
[28]
Vanguardia et al., 2014 41 Male Cauda equina No Incomplete
[29]
elements. Because their capsule typically adheres to disturbed developmental environment like a primitive
the spinal cord, radical removal carries a high risk of streak or a caudal cell mass, differentiate chaotically, and
neurological defi cits. create spinal teratoma. The dysraphic malformations
[33]
and the occurrence of a neurenteric cyst without
The pathogenesis of spinal intradural teratomas is still a [34]
subject of debate. The two widely held theories regarding dysraphism support this theory, and the tridermal
the origin of intraspinal teratomas are the misplacement anomaly, under such considerations, represents the
[33]
germ cell theory and the dysembryogenic theory. [7,16] The primary event that will further affect the spinal closure.
traditional theory is the misplacement germ cell theory. The indications for surgery in an adult with intraspinal
It suggests that certain pluripotent primordial germ cells mature teratoma are controversial. Radical resection
of the neural tube are misplaced during their migration to should be the goal in symptomatic cases with radicular
the gonadal ridges from the primitive yolk sac, resulting pain and/or progressive signs due to mass effect or
in spinal teratoma formation. In our situation, there is cord tethering. On the other hand, asymptomatic
[17]
[7]
enough evidence to support the rationale of this theory, patients and those having longstanding minor and stable
since we found that only 16% of adult cases were neurological defi cits may be treated conservatively,
associated with spinal dysraphism [16,21,26] and that the because prophylactic surgery can be associated with a
lower thoracic vertebrae and the conus medullaris region, high surgical risk in adult patients with no growing or
which are adjacent to the caudal cell mass, represent the very slow-growing lesions.
most common locations in adult population.
Some authors advise the removal of the capsule
[35]
The alternative explanation comes from the as a potential source of regrowth. However, an
[36]
dysembryogenic theory. This theory indicates that spinal epidemiological study guided by Allsopp et al. showed
teratomas arise from pluripotent cells which, in a locally that recurrence rates for complete and gross resection
108 Journal of Cancer Metastasis and Treatment ¦ Volume 1 ¦ Issue 2 ¦ July 15, 2015 ¦