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CasediscussionBoneGroup2016.12.22HistoryMale,25yChiefcomplaint:interspinalmassDiagnoseapproachFinaldiagnosisIntraspinalteratomaDiagnoseapproachIntroductionTeratomascanbesubdividedintothreegroups:monodermomadidermomatridermomaTwotypesexist:1)matureteratomascomposedofwell-differentiatedelements2)immatureteratomasthatcontainprimitiveelementsIntroductionMostintraspinalteratomaslocatedinthedorsalordorsolateralpartofthespinalCanbeepidural,intraduralextramedullaryandintramedullary70%arebenignSpinalcordandnerverootcompressionmayappeardependingonthelocationMixedsignalcharacteristicssuggestiveofbothsolidandcysticcomponentsContainedconnectivetissue,fat,andcartilageMayassociationwithasplitcordmalformation,myelomeningocele,orlipomyelomeningoceleRadiographicsignsX-ray:

thoracolumbarscoliosisandmultiplevertebralstructuralabnormalitiesCT:spinalmalformation&interspinalmasswithfatandcalcificationMR:RadiographicsignsDDXLipomaslocationEpidermoidcystforcontentDermoidcystenhancement

IntraspinallipomasIntraspinallipomasarerare(accountingfor1%ofallintraspinaltumors)ClinicalsymptomsusuallyresultedfromcordcompressionandduetosecondarytetheringofthespinalcordMostlocatedinthelumbosacralarea(90%)Excludingthelumbosacralspine,thoracicin32%,cervicothoracicin24%,andcervicalin13%IntraspinallipomasThemarginofthelipomawaswelldemarcate(Spinalmalformation&causewideningofthespinalcanal&tetheredcordsyndrome)CT:homogenouslylow-density(-100HU)MRI:hyperintensityonT1andT2,hypointensityonfatsupprenssionsequencesEnhancementbehavior:noormildIntraspinalepidermoidcystSpinalcutaneousinclusiontumorsmaydevelopafterintroducingcutaneouscellsintheCNSRare,benignandslow-growingtumorsCongenitaloracquired(historyoflumbarpunctureorinjury)Asoftwhitebulk,richincholesterolcrystalsIntraspinalepidermoidcystEpidermoidtumorsarewell-circumscribed,encapsulatedlesionsMR:Hypo-orisointenseonT1,hyperintenseonT2,andmaybehomogeneousorheterogeneousEnhancementbehavior:noormild(rim)However,thesignalcharacteristicsofepidermoidtumorsvarywidelyIntraspinaldermoidcystClinicalpresentation,radiologicalcharacteristics,intraoperativefindingsandoutcomedonotdifferfromepidermoidcystInthelumbosacralregion,epidermoidtumorismorecommon,dermoidtumorisrelativelyuncommonWithepidermaladnexa,suchashairfollicles,sebaceousglandsandsweatglandsIntraspinaldermoidcystWell-defined,smooth,opaque,roundorovalmassesUsuallyhyper-onT1andhypo-onT2Mixedsignalmassbyothercomponentssuchashair,glandularandsweatsecretionDifficulttodifferentiateitfromthealipomawithahighlipidcontentandunsaturatedfattyacidswithoutcholesterolSummaryToknowwhattypeofatumorislikelytobeencounteredofthecaudaequinaareaimagingcharacteri

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