Complex split cord malformation with mediastinal extension of a teratoma and simultaneous ventral and dorsal bony spur splitting the cord.

INTRODUCTION: Association of split cord malformation with teratoma is an extremely rare condition. It is very unusual to find split cord malformation with teratomas extending into the posterior mediastinum and still rarer to find bony spur arising dorsally and ventrally at the same level. CASE REPORT: The authors describe the case of a 2-year-old child who presented with dorsal kyphosis and a dermal sinus. The neurological examination was unremarkable. MRI and noncontrast CT of the spine revealed Pang's type I split cord malformation at the D9-12 level. Bony spur was seen arising both dorsally and ventrally at the D9-12 level. Intraoperatively, intradural teratoma was found coming extradurally both posteriorly between the 2 spurs and anteriorly into the posterior mediastinum above the bony spurs through a defect in the vertebral body of 2 cm diameter. Near total excision was performed. DISCUSSION: To the best of the authors' knowledge, this is the second case report of an intradural teratoma extending into the mediastinum, occurring with split cord malformations and other spinal anomalies. A similar case was reported from our institute in 2006. This is the first report of its kind of simultaneous dorsal and ventral bony spur at the same level.