Child's Nervous System

, Volume 35, Issue 2, pp 369–372 | Cite as

Enlarging teratoma syndrome

  • İdris SertbaşEmail author
  • Mete Karatay
Case Report



Teratomas are derived from all three germ layers and make up 3% of all childhood tumors. They are histologically classified as mature or immature. We present a case that was operated on when 30 days old for a sacrococcygeal mature teratoma and then showed long segment involvement in the thoracolumbar region 9 months after the surgery. The MRI (magnetic resonance imaging) showed a mass starting at the thoracal 4 level and extending to the lumbar 3 level with significant spinal cord compression in the extradural space.


The laminae between thoracal 4 and lumbar 3 levels were removed en bloc at a single surgical session and laminoplasty was performed after tumor resection. We also removed the tumor growing into the extrapleural space at the thoracal 5, 6, and 9, 10, 11, 12 levels using the costotransversectomy procedure.


We emphasize with this case that mature teratomas can show aggressive growth following surgery and that the development of spinal deformities can be prevented with laminoplasty.


Mature teratoma Epıdural tumor Pediatric spine surgery 


Compliance with ethical standards

Conflict of interest

There are no reported conflicts of interest for all authors.


  1. 1.
    Akinkuotu AC, Coleman A, Shue E, Sheikh F, Hirose S, Lim FY, Olutoye OO (2015) Predictors of poor diagnosis in prenatally diagnosed sacrococcygeal teratoma: a multi-institutional review. J Pediatr Surg 50:771–774. CrossRefGoogle Scholar
  2. 2.
    Azizkhan RG, Caty MG (1996) Teratomas in childhood. Curr Opin Pediatr 8(3):287–292CrossRefGoogle Scholar
  3. 3.
    Carr BI, Gilchrist KW, Carbone PP (1981) The variable transformation in metastases from testicular germ cell tumors: the need for selective biopsy. J Urol 126:52–54CrossRefGoogle Scholar
  4. 4.
    De Backer A, Madern GC, Hakvoort-Cammel FGAJ, Haentjens P, Wolter Oosterhuis J et al (2006) Study of the factors associated with recurrence in children with sacrococcygeal teratoma. J Pediatr Surg 41(1):173–181. CrossRefGoogle Scholar
  5. 5.
    DiSaia PJ, Saltz A, Kagan AR, Morrow CP (1977) Chemotherapeutic re of immature teratoma of the ovary. Obstet Gynecol 49:346–350Google Scholar
  6. 6.
    Fujimaki T (2009) Central nervous system germ cell tumors: classification, clinical features, and treatment with a historical overview. J Child Neurol 24(11):1439–1445. CrossRefGoogle Scholar
  7. 7.
    Harms D, Zahn S, Gobel U, Schneider DT (2006) Pathology and molecular biology of teratomas in childhood and adolescence. Klin Padiatr 218(6):296–302CrossRefGoogle Scholar
  8. 8.
    Jelin E, Jelin AC, Lee H (2009) Sacrococcygeal teratoma with spinal canal invasion prenatally diagnosed. J Pediatr Surg 44:E9–E11. CrossRefGoogle Scholar
  9. 9.
    Kalani MY, Iyer S, Coons SW, Smith KA (2012) Spinal intradural teratomas: developmental programs gone awry? Neurosurg Focus 33(4):E1CrossRefGoogle Scholar
  10. 10.
    Kremer MEB, Wellens LM, Derikx JPM, Van Baren R, Heij HA, Wijnen MH et al (2016) Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma. J Pediatr Surg 51:1826–1829. CrossRefGoogle Scholar
  11. 11.
    Logothetis CJ, Samuels ML, Trindade A, Johnson DE (1982) The growing teratoma syndrome. Cancer 50:1629–1635CrossRefGoogle Scholar
  12. 12.
    Lu YH, Wang HH, Lirng JF, Guo WY, Wong TT, Teng MM et al (2013) Unusual giant intraspinal teratoma in an infant. J Chin Med Assoc 76:411–414. CrossRefGoogle Scholar
  13. 13.
    Makary R, Wolfson D, Dasilva V, Mohammadi A, Shuja S (2007) Intramedullary mature teratoma of the cervical spinal cord at C1-2 associated with occult spinal dysraphism in an adult. J Neurosurg Spine 6(6):579–584CrossRefGoogle Scholar
  14. 14.
    Merrin C, Baumbgartner G, Wajsman Z (1975) Benign transformation of testicular carcinoma by chemotherapy. Lancet 1:43–44CrossRefGoogle Scholar
  15. 15.
    Phi JH, Kim SK, Park SH, Hong SH, Wang KC, Cho BK (2005) Immature teratomas of the central nervous system: is adjuvant therapy mandatory? J Neurosurg 103(6 suppl):524–530Google Scholar
  16. 16.
    Rattan KN, Malik V, Khurana P, Dhawan S, Kaushal V, Maggu S (2001) Teratomas in infancy and childhood. Indian J Pediatr 68(2):117–120CrossRefGoogle Scholar
  17. 17.
    Schneider DT, Wessalowski R, Calaminus G, Pape H, Bamberg M, Engert J, Waag K, Gadner H, Göbel U (2001) Treatment of recurrent malignant sacrococcygeal germ cell tumors: analysis of 22 patients registered in the German protocols MAKEI 83/86, 89, and 96. J Clin Oncol 19(7):1951–1960. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Deparment of NeurosurgeryYeni yüzyıl Univercity Medical of SchoolİstanbulTurkey

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