TY - JOUR
T1 - Malignant Transformation of a Filum Terminale Dermoid Tumor into Adenocarcinoma
AU - Asmaro, Karam
AU - Abouelleil, Mohamed
AU - Haider, Sameah
AU - Zakaria, Hesham Mostafa
AU - Gradinaru, Ciprian
AU - Mukherjee, Abir
AU - Lee, Ian
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/7
Y1 - 2019/7
N2 - Background: Intraspinal dermoid tumors are usually rare benign growths that occur as a result of defects during neural tube formation. They make up less than 1% of tumors in the spine and are associated with spinal dysraphisms or sinus tracts. Although rare, malignant transformation into squamous cell carcinoma has been previously reported. Malignant transformation into adenocarcinoma, however, represents a novel phenotypic differentiation pattern that is hitherto undescribed. Case Description: A 45-year-old woman presented with acute symptoms of cauda equina syndrome. Imaging of the spine revealed a large intradural sacral mass. The lesion was surgically resected with pathology revealing a dermoid tumor with malignant transformation into adenocarcinoma. Metastatic workup revealed no other suspicious lesions. The patient had an uneventful postoperative course, gradually regaining micturition control. Conclusions: Dermoid tumors, also known as benign cystic teratoma or mature teratoma, are usually benign congenital tumors comprising epithelial cells that arise from displaced embryonic ectoderm and mesoderm during neural tube formation. Although extremely rare, malignant transformation into squamous cell carcinoma has been reported. This case represents the first report of an intraspinal dermoid tumor transforming into adenocarcinoma. A comprehensive histopathologic analysis is key to identifying the lesion and guiding postsurgical management.
AB - Background: Intraspinal dermoid tumors are usually rare benign growths that occur as a result of defects during neural tube formation. They make up less than 1% of tumors in the spine and are associated with spinal dysraphisms or sinus tracts. Although rare, malignant transformation into squamous cell carcinoma has been previously reported. Malignant transformation into adenocarcinoma, however, represents a novel phenotypic differentiation pattern that is hitherto undescribed. Case Description: A 45-year-old woman presented with acute symptoms of cauda equina syndrome. Imaging of the spine revealed a large intradural sacral mass. The lesion was surgically resected with pathology revealing a dermoid tumor with malignant transformation into adenocarcinoma. Metastatic workup revealed no other suspicious lesions. The patient had an uneventful postoperative course, gradually regaining micturition control. Conclusions: Dermoid tumors, also known as benign cystic teratoma or mature teratoma, are usually benign congenital tumors comprising epithelial cells that arise from displaced embryonic ectoderm and mesoderm during neural tube formation. Although extremely rare, malignant transformation into squamous cell carcinoma has been reported. This case represents the first report of an intraspinal dermoid tumor transforming into adenocarcinoma. A comprehensive histopathologic analysis is key to identifying the lesion and guiding postsurgical management.
KW - Dermoid cyst
KW - Filum terminale dermoid tumor
KW - Intraspinal adenocarcinoma
KW - Malignant intraspinal dermoid
KW - Malignant transformation
KW - Spinal benign cystic teratoma
KW - Spinal mature teratoma
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U2 - 10.1016/j.wneu.2019.03.031
DO - 10.1016/j.wneu.2019.03.031
M3 - Article
C2 - 30872204
AN - SCOPUS:85064320975
SN - 1878-8750
VL - 127
SP - 15
EP - 19
JO - World neurosurgery
JF - World neurosurgery
ER -