Intracavernous Teratoma in a School-Aged Child

Abstract

An eight-year-old boy presented with left eye pain, photophobia, proptosis, third nerve paresis and decreased visual acuity. Magnetic resonance imaging revealed a nonenhancing mass filling the cavernous sinus. Using an extradural fronto-orbitozygomatic approach, the cavernous sinus was approached laterally, and a teratoma was removed from within the cavernous sinus. This is the first case of a truly intracavernous teratoma in a child and the fourth case of a teratoma reported in the cavernous sinus region overall. This report outlines the diagnosis and treatment of this unusual cavernous sinus tumor.

Mature Teratouna Arising From the Sella. Case Report.

“…Immature form teratoma appears with smaller and less prominent cysts and calcification but may be associated with peritumoral edema. 1) The understanding of the natural history of intracranial teratomas is still incomplete, partly due to the low incidence. 24,25) Intrasellar mature teratoma has the potential to undergo ossification, teeth formation, melanotic progonoma, and malignant transformation.…”

“…17) Occasional cases of teratoma are reported in the basal ganglia, cavernous sinus, fourth ventricle, and the sylvian fissure. 1,4,15,16,19) Teratomas arising within the sella turcica are uncommon. 23) Intrasellar teratoma comprising of only mature elements is extremely rare.…”

Congenital Cavernous Sinus Cystic Teratoma

“…A second case was recently reported by Becherer et al1 The authors exhaustively reported clinical, diagnostic, and pathological findings of the tumor, and concluded that teratomas are resectable lesions with a low morbidity rate (defined mainly by the extent of cranial nerve dysfunction).…”

“…Microscopically, they consist of solid and cystic portions of squamous epithelium with keratin debris 1. They contain fully mature tissue of ectodermal, mesodermal, and endodermal origin.…”

“…Less often, they occupy the lateral ventricles or the posterior fossa in the cerebellopontine angle. One of the rarest locations is the lateral wall of the cavernous sinus; only three pure intracavernous teratomas have been reported 1-3. Here, we present a rare case of a cystic congenital mature teratoma arising within the cavernous sinus of a three-month-old boy.…”