Cystic teratoma of the conus

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Sciatica

Patient Data

Age: 30 years
Gender: Female
mri
This study is a stack
Sagittal
T1
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Axial
T1
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Sagittal
T2
This study is a stack
Axial
T2
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal
T1 fat sat
This study is a stack
Sagittal
T2 fat sat
This study is a stack
Sagittal
Gradient Echo
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Info

A mass in the conus is present which is mostly cystic but with solid components some of which are fatty. 

Case Discussion

The patient went on to have a laminectomy and resection of the mass, confirmed to be intrathecal. 

Histology

Sections show fragments of benign stratified squamous epithelium, glandular epithelium, keratin debris, extravasated mucin and adipose tissue. No intraepithelial goblet cells are identified, confirmed by negative PAS/PASD stains.

Immunohistochemistry results show glandular epithelial cells stain EMA+, CK20- and CDX2-. The Topoisomerase proliferation index is <1%.

FINAL DIAGNOSIS: Benign cystic teratoma.

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