Massive teratomas involving the cranial base: treatment and outcome--a two-center report.

Massive teratomas involving the cranial base are extremely rare, and to our knowledge, there are no reports of this condition in surviving children. We describe the management of four cases of massive intracranial teratomas, reflecting a combined experience from two major referral centers. We found that when corrected at an early age, the brain parenchyma demonstrated a remarkable ability to reexpand in those children who had appeared to have sustained parenchymal deficits secondary to the mass effect from the tumor. Follow-up thus far suggests that regional skull growth potential may be compromised in some of these patients. Often, the exact pathologic diagnosis of these entities is somewhat different, since they may fall somewhere within the hamartoma-heterotopia-teratoma continuum. We believe that the best care of these children is offered through a combined simultaneous craniofacial and neurosurgical approach.