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BackgroundIntradural extramedullary teratomas in the cervical or cervicomedullary region are rare in adults.Case descriptionWe report a symptomatic, mature teratoma at the cervicomedullary junction in a 52-year-old Hispanic female who also has a type I diastematomyelia in the thoracolumbar spine. The patient underwent surgical resection of the lesion with the resolution of presenting symptoms. Histopathology of the lesion revealed a mature cystic teratoma with pulmonary differentiation.ConclusionWe discuss the case along with a review of pertinent literature and considerations with regard to the diagnosis, etiology, prognosis, and management of this unusual pathology.

To assess volumetric changes in the spinal cord at the cervicomedullary junction, diameter of the cervicomedullary cord, and width of the brainstem following posterior fossa decompression (PFD). A retrospective analysis of adult patients with Chiari malformation who underwent PFD was performed. Segmentations were done on clinical quality T2-weighted cervical magnetic resonance images obtained before and after decompression using ITK-SNAP. Volumes of neural tissue within the cervicomedullary junction were evaluated from 10 mm cranial to the medullary beak to the cervical spinal cord at the level of the caudal endplate of the second cervical vertebra. The diameter of the cervicomedullary cord was calculated perpendicular to the spinal cord. The width of the brainstem was measured perpendicular to the clivus at the level of the basion. Twenty adult patients, a mean age of 49.55 years, were included. The cervical cord increased in volume by 13 mm3 to 338 mm3, with an average increase of 155 mm3 (P -value of 0.00002). The diameter of the cervicomedullary cord increased 10.30% 7 mm superior to the beak (P -value of 0.00074), 11.49% at the apex of the beak (P -value of 0.00082), 8.29% 7 mm inferior to the beak (P -value of 0.00075), and the brainstem increased 14.46% perpendicular to the clivus (P -value of 0.00109). The spinal cord at the inferior aspect of the C3 vertebra changed insignificantly (P -value of 0.10580). The volume of the cervical cord at the cervical-medullary junction, width of the cervicomedullary cord, and diameter of the brainstem increase following PFD. [ABSTRACT FROM AUTHOR]

Introduction: Spinal cord injury (SCI) is most common following trauma, typically involving motor vehicle incidents. The clinical prognosis depends on many factors, most importantly the initial grade of injury., Case Report: We present a 26-year-old male who presents to the emergency department after a motor vehicle accident. He sustained significant injuries with an initial Glasgow Coma Scale of 3 and signs of complete SCI. A computed tomography scan demonstrated cervicomedullary transection caused by C6-C7 facet distraction with C6 retrolisthesis on C7. The patient recovered the ability to track with eyes, utilize facial expression, and unilateral trapezius function to command. Neurological recovery was not made despite aggressive treatment., Conclusion: Patients with complete SCI typically have poor outcomes despite aggressive treatment. We present a unique mechanism, treatment, and outcome of a cervicomedullary SCI through C6 retrolisthesis on C7., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Hemangioblastoma is a rare, benign, highly vascularized tumour, that usually presents a muriform nodule. The most frequent localization is the posterior cranial fossa. The frequency of this spinal lesion is very low, representing less than 5% of spinal cord tumours. The presentation of hemangioblastoma can widely vary, from a solid tumour to a lesion with a cystic component. We present the case of a 43 years old patient, admitted to our clinic for left hemiparesis, swallowing disorders, and dysphonia. An MRI is performed and it showed a cervicomedullary junction tumour with a solid nodule and an anterior cystic cavity pushing towards the 4th ventricle. The patient underwent surgery for the total removal of the tumour. Post-operative CT confirmed the total ablation of the tumour. The patient is discharged with improved symptomatology. In the last 10 years, in our clinic were admitted 23 cases of hemangioblastoma, 14 males (61% of the patients) and 9 females (39%) with an age at presentation varied from 14 to 78 years (mean 48,2 years). Only 3 patients (13%) out of the 23 had associated von Hippel-Lindau syndrome, with hemangioblastomas also present in other locations. The most common location was the posterior fossa, in 13 cases (56,6%). Headache (69,5%), ataxia (56%) and balance disorders (52%) were the most common symptoms accused by patients. The followup varied from 6 to 84 months (mean 20 months). Only one patient died during hospitalization and one tumour recurrence was noted. Most patients improved or remained clinically stable postoperatively. [ABSTRACT FROM AUTHOR]

Pilocytic astrocytomas are well-circumscribed, predominantly cystic mass lesions that have a discrete mural nodule. Giant, solid pilocytic astrocytoma is uncommon. Its characteristic imaging features are described.

Hemangioblastoma is a rare, benign, highly vascularized tumour, that usually presents a muriform nodule. The most frequent localization is the posterior cranial fossa. The frequency of this spinal lesion is very low, representing less than 5% of spinal cord tumours. The presentation of hemangioblastoma can widely vary, from a solid tumour to a lesion with a cystic component. We present the case of a 43 years old patient, admitted to our clinic for left hemiparesis, swallowing disorders, and dysphonia. An MRI is performed and it showed a cervicomedullary junction tumour with a solid nodule and an anterior cystic cavity pushing towards the 4th ventricle. The patient underwent surgery for the total removal of the tumour. Post-operative CT confirmed the total ablation of the tumour. The patient is discharged with improved symptomatology. In the last 10 years, in our clinic were admitted 23 cases of hemangioblastoma, 14 males (61% of the patients) and 9 females (39%) with an age at presentation varied from 14 to 78 years (mean 48,2 years). Only 3 patients (13%) out of the 23 had associated von Hippel–Lindau syndrome, with hemangioblastomas also present in other locations. The most common location was the posterior fossa, in 13 cases (56,6%). Headache (69,5%), ataxia (56%) and balance disorders (52%) were the most common symptoms accused by patients. The follow-up varied from 6 to 84 months (mean 20 months). Only one patient died during hospitalization and one tumour recurrence was noted. Most patients improved or remained clinically stable postoperatively.

Pilocytic astrocytomas are well-circumscribed, predominantly cystic mass lesions that have a discrete mural nodule. Giant, solid pilocytic astrocytoma is uncommon. Its characteristic imaging features are described. [ABSTRACT FROM AUTHOR]

Background: Intradural extramedullary teratomas in the cervical or cervicomedullary region are rare in adults., Case Description: We report a symptomatic, mature teratoma at the cervicomedullary junction in a 52-year-old Hispanic female who also has a type I diastematomyelia in the thoracolumbar spine. The patient underwent surgical resection of the lesion with the resolution of presenting symptoms. Histopathology of the lesion revealed a mature cystic teratoma with pulmonary differentiation., Conclusion: We discuss the case along with a review of pertinent literature and considerations with regard to the diagnosis, etiology, prognosis, and management of this unusual pathology., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Surgical Neurology International.)

Background: Cervicomedullary glioblastoma is an extremely rare clinical entity and the principles of its management are not well understood., Case Description: We report two cases of cervicomedullary glioblastoma in young patients aged 12 and 30 years with contrasting clinical presentation and outcomes. The 12-year-old child had rapid onset bulbar symptoms, with frank infiltration of the medulla due to which the patient succumbed within 4 weeks of surgery. The 30-year-old adult had a relatively slow disease onset and progression and made a good neurological recovery without disease progression at 16 months after surgery. To the best of our knowledge, we also report only the second adult patient in the literature with a dorsally exophytic cervicomedullary glioblastoma. Difficulties in diagnosis and management are discussed with a review of the pertinent literature., Conclusion: The overall outcome depends on the rapid progression and severity of preoperative symptoms and the degree of tumor infiltration noted in imaging and during surgery., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Surgical Neurology International.)