neuroplex
New York Association of Neuropathologists
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.
