Mediastinal extension of an intradural teratoma in a patient with split cord malformation: case report and review of literature.

INTRODUCTION: It is very rare for split cord malformation to be associated with intraspinal teratoma, and it is even rarer for such tumors in the dorsal spine to extend into the mediastinum. CASE REPORT: The authors describe a spinal teratoma with mediastinal extension in an 8-year-old boy who presented with 1-year history of backache. Neuroimaging revealed a heterogeneously enhancing intradural lesion from D2 to D7 levels with an extension into the mediastinum at the level of D4 vertebra. A split cord malformation type 2 and a cervical syrinx were also present. At surgery, a reddish-brown vascular tumor was present from D3 to D5 levels and was found to be going anteriorly into a defect in the body of D4 vertebra. Gross total excision of the intraspinal tumor was performed. Follow-up at 1 year revealed no recurrence or metastases. DISCUSSION: To the authors' knowledge, this is the first case of an intradural teratoma extending into the mediastinum, occurring concurrently with split cord malformation and other spinal anomalies.