The rare case of an intramedullary cervical spinal cord teratoma in an elderly adult: Case report and literature review

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. © 2009, Lippincott Williams & Wilkins.