7/10/2007 Case 2: Mature teratoma with papillary neoplasm, malignant


Clinical History:

This lesion is from a 36year old man who had progressive lower extremity weakness for over one year, with pain and loss of bowel control. MRI disclosed a heterogeneous intradural mass at L2-L3, below the level of the conus medullaris but possibly attached to it, also involving nerve roots of the cauda equina. The pre-operative diagnosis was schwannoma. A biopsy of the center of the mass was sent for frozen section, revealing a neoplasm. The entire mass was then nearly totally excised, but it could not be dissected away from all of the nerve roots without sacrificing some of the nerves. Post-operatively, the patient is reported to have no residual weakness. The specimen was entirely intradural, and it appeared at surgery to be below the level of the spinal cord.

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