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Without any known specific cause a 3-year-old boy developed a torticollis. Although the symptoms were treated immediately there was no improvement. Four months later X-rays showed that the dens-atlas distance was enlarged. In spite of this, he was treated by tenotomy and intensive physiotherapy, but the torticollis remained. Two years later a tomogram and a CT showed a complete rotatory dislocation between atlas and axis. At this stage it was impossible to treat the original cause. Physiotherapy was continued to improve the position of the head.

dyspnea, and pain. In 21 of their 58 cases, chest mass was found on routine x-ray examination.Lyons and co-workers5 found 35 teratoid lesions among 782 mediastinal masses -studied, only 2 being in the posterior mediastinum. They reported that 30% showed malignant changes.GrossJ reported 5 cases of teratoma, 2 malignant and fatal. Svien and co-workers4 reported paraplegia as a complication of a dumbbell ganglioneuroma of the cord. Ellis also described in 5 of his cases-all ganglioneuromas-invasion of the cord. We have, however, found no reference to paraplegia from a teratocarcinoma.Dhahran Health Center (Dr. Howard).

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