To explore the diagnosis and treatment of adult-onset intradural spinal teratoma.

A retrospective study was conducted on 11 adult patients with intradural spinal teratoma who were surgically treated and pathologically confirmed at Department of Neurosurgery, General Hospital of Ningxia Medical University between January 2013 and August 2019. All patients underwent surgical resection of the tumor via posterior laminectomy approach under neuroelectrophysiological monitoring. The extent of tumor resection was evaluated based on the patient’s postoperative MRI. Limb motor function was assessed using muscle strength score. Bladder function was evaluated by the Japanese Orthopaedic Association (JOA) sphincter function score. The long-term efficacy of the patients was assessed using McCormick clinical classification.

Of the 11 patients in our study, all the lesions were located in the lumbosacral region, and the imaging manifestations were complex and vary greatly. The clinical manifestations included pain in the lumbosacral region and unilateral lower limb in 9 cases, urinary incontinence in 1. Of the 11 included patients, 3 patients received total resection and the other 8 patients received subtotal resection. All results of pathological diagnosis were teratomas, 10 cases were diagnosed with mature teratoma and 1 case was diagnosed with mature teratoma with partial carcinoid tissues. The median follow-up time of the 11 patients was 15 months (9 months to 8 years). During the follow-up period, enhanced MRI was performed, and no tumor recurrence or spinal instability was observed. The McCormick grading scale evaluation results of the last follow-up showed that functional status was improved in 8 cases and remained unchanged in the other 3 patients, and there was no case reporting aggravation.

Adult-onset intradural spinal teratoma are rare and commonly occur in the lumbosacral region. The clinical manifestation of intradural spinal teratoma lacks specificity, and MRI manifestations are complex and diverse. Radical excision of microsurgery under electrophysiological monitoring seems the optimal treatment.

Teratoma; Spinal canal; Adult; Neurosurgical procedures; Treatment outcome