PMC4055415_01
Pre-operative thoracolumbar spinal MR image detailing a 7.5 mm x 14 mm x 14 mm elongated cystic mass, with mixed T2 signal intensity in the dorsal epidural space extending from the T3-T10 vertebral levels (A). Post-operative enhancement of the dorsal epidural space in the area of the excised lesion (B). Pre-operatively, there is severe pre-operative spinal cord compression, with the cystic components extending into the T5-T6 and T6-T7 intervertebral foramina (C-D).
cpath-7-2014-015f1.jpg
PMC4055415_01_cpath-7-2014-015f1.jpg
f1-cpath-7-2014-015
T2 signal intensity and faint gadolinium enhancement, in the dorsal epidural space extending from the T3-T10 vertebral levels (Fig. 1A). There was severe spinal cord compression, with the cystic components of the mass extending into the T5-T6 and T6-T7 intervertebral foramina (Fig. 1A, C, D).
Intraoperative photographs detailing bilateral laminectomies from T3 to T10 (A), with the lesion noted to be a yellow, cystic epidural mass extending from T3 to T9 with neural foraminal extension (B). No intradural component was observed, and gross total resection was achieved (C).
cpath-7-2014-015f2.jpg
PMC4055415_01_cpath-7-2014-015f2.jpg
f2-cpath-7-2014-015
On gross examination, the mass was heterogeneous in appearance, with tissue resembling muscle, cartilage, and hair, consistent with a teratoma (Fig. 2).
Histologic examination was consistent with a teratoma (hematoxylin and eosin). The teratoma contained a range of tissue types including (A) simple columnar epithelium with intermixed mucin secreting goblet cells resembling intestinal epithelium, original magnification x40; (B) canalicular appearance of the dermoid cyst composed of multilayered stratified squamous epithelium with keratin debris and adnexal structures, original magnification x20; (C) focus with angiomatous differentiation, original magnification x40; (D) well-differentiated mucous glands, original magnification x40; and (E) focus with smooth muscle differentiation, original magnification x40.
cpath-7-2014-015f3.jpg
PMC4055415_01_cpath-7-2014-015f3.jpg
f3-cpath-7-2014-015
A gross total resection was achieved and on histologic examination, the mass lesion was consistent with a mature teratoma, containing numerous well-differentiated cell types including stratified squamous epithelium, simple columnar epithelium, smooth muscle, mucous glands, as well as angiomatous differentiation (Fig. 3).
PMC4055415_02
PMC4055415_03
PMC4055415_04
PMC4055415_05