Age / Sex : 65 / M

Chief complaint : Nocturia


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy : 김 완 태(Wan Tae Kim), 중앙보훈병원(Veterans Health Service Medical Center)

Mature teratoma

Discussion

Findings

  - CT :

• A sagittal CT image reveals a mixed density soft tissue mass lesion that occupy the intradural space along the spinal cord. The mass lesion is composed of low density fat, isodensity tissue and small areas of calcification.

- MRI :

• A sagittal T1-weighted image reveals a well-defined intradural and intramedullary lesion, which is markedly heterogeneous with areas of hyperintense fat and isointense tumor.


• A sagittal T2-weighted image demonstrates a very hyperintense mass lesion with additional area of intermediate signal intensity.


• A sagittal enhanced T1-weighted image shows heterogenous enhancement of soft tissue mass and non enhancing fatty component.

• Myxopapillary ependymoma


• Astrocytoma


• Hemangioblastoma


• Intradural lipoma

1.Adult-onset intradural spinal teratoma: report of 18 consecutive cases and outcomes in a single center. Wan W, Yang C, Yan W, Liu T, Yang X, Song D, Xiao J. Eur Spine J. 2017 Jul;26(7):1917-1928.

2.MRI findings in intraspinal mature teratoma. Wang H, Huang Y, Nie P, Dong C, Hou F, Hao D, Xu W. Clin Radiol. 2016 Jul;71(7):717.e1-8.

3.A case of conus medullaris teratoma. Lekgabe E, Rogers TW, Laidlaw J, Lui E, Gaillard F. J Clin Neurosci. 2018 Jan;47:123-126.