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Casediscussion BoneGroup2016 12 22 History Male 25yChiefcomplaint interspinalmass Diagnoseapproach Finaldiagnosis Intraspinalteratoma Diagnoseapproach Introduction Teratomascanbesubdividedintothreegroups monodermomadidermomatridermomaTwotypesexist 1 matureteratomascomposedofwell differentiatedelements2 immatureteratomasthatcontainprimitiveelements Introduction MostintraspinalteratomaslocatedinthedorsalordorsolateralpartofthespinalCanbeepidural intraduralextramedullaryandintramedullary70 arebenignSpinalcordandnerverootcompressionmayappeardependingonthelocation MixedsignalcharacteristicssuggestiveofbothsolidandcysticcomponentsContainedconnectivetissue fat andcartilageMayassociationwithasplitcordmalformation myelomeningocele orlipomyelomeningocele Radiographicsigns X ray thoracolumbarscoliosisandmultiplevertebralstructuralabnormalitiesCT spinalmalformation interspinalmasswithfatandcalcificationMR Radiographicsigns DDX LipomaslocationEpidermoidcystforcontentDermoidcystenhancement Intraspinallipomas Intraspinallipomasarerare accountingfor1 ofallintraspinaltumors ClinicalsymptomsusuallyresultedfromcordcompressionandduetosecondarytetheringofthespinalcordMostlocatedinthelumbosacralarea 90 Excludingthelumbosacralspine thoracicin32 cervicothoracicin24 andcervicalin13 Intraspinallipomas Themarginofthelipomawaswelldemarcate Spinalmalformation causewideningofthespinalcanal tetheredcordsyndrome CT homogenouslylow density 100HU MRI hyperintensityonT1andT2 hypointensityonfatsupprenssionsequencesEnhancementbehavior noormild Intraspinalepidermoidcyst SpinalcutaneousinclusiontumorsmaydevelopafterintroducingcutaneouscellsintheCNSRare benignandslow growingtumorsCongenitaloracquired historyoflumbarpunctureorinjury Asoftwhitebulk richincholesterolcrystals Intraspinalepidermoidcyst Epidermoidtumorsarewell circumscribed encapsulatedlesionsMR Hypo orisointenseonT1 hyperintenseonT2 andmaybehomogeneousorheterogeneousEnhancementbehavior noormild rim However thesignalcharacteristicsofepidermoidtumorsvarywidely Intraspinaldermoidcyst Clinicalpresentation radiologicalcharacteristics intraoperativefindingsandoutcomedonotdifferfromepidermoidcystInthelumbosacralregion epidermoidtumorismorecommon dermoidtumorisrelativelyuncommonWithepidermaladnexa suchashairfollicles sebaceousglandsandsweatglands Intraspinaldermoidcyst Well defined smooth opaque roundorovalmassesUsuallyhyper onT1andhypo onT2Mixedsignalmassbyothercomponentssuchashair glandularandsweatsecretionDifficulttodifferentiateitfromthealipomawithahighlipidcontentandunsaturatedfattyacidswithoutcholesterol Summary Toknowwhattypeofatumorislikelytobeencounteredofthecaudaequinaareaimagingcharacteristicsinc
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