Teratoma in the Fourth Ventricle of an Elderly Adult

Harada, Kiyoshi; Okamoto, Hirofumi; Fujioka, Yoshimi; Kiya, Katsuzo; Mukada, Kazutoshi; Uozumi, Tohru; Itoh, Hisao

doi:10.2176/nmc.24.499

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Most previous reports showed gross total or subtotal resection. Harada et al [ 10 ] reported a fourth ventricle mature teratoma in a 62-year-old male patient. The patient underwent gross total resection, and the tumor did not recur for 4 years.…”

Section: Discussionmentioning

confidence: 99%

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Posterior Fossa Teratomas in Adults : A Systematic Review

Shin

Kim

Song

et al. 2021

J Korean Neurosurg Soc

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The occurrence of posterior fossa teratomas in adulthood is extremely rare. In this study, we aimed to report our experience with two cases of posterior fossa mature teratoma in adults who underwent surgical resection. We also performed a systematic review of published papers available to date. Methods : We retrospectively reviewed the electronic medical records of patients who had onset of posterior fossa teratomas in adulthood at our institute between 1995 and 2020. We evaluated the clinical, radiographic, and pathological features of mature teratomas at the posterior fossa in adulthood. Furthermore, we searched the PubMed, EMBASE, and Web of Science database and reviewed published articles. Results : We found 507 articles on database review; of them, 102 were duplicates and 389 were excluded based on the inclusion criteria. Finally, 16 cases of posterior fossa from the web search and related articles. Subsequently, we added two cases that underwent surgery at our institute. We analyzed a total of 18 cases of mature teratomas. Headache was the most common (55.6%) symptom. The teratomas showed heterogeneous signals on magnetic resonance imaging. Thirteen patients (72.2%) had lesion at midline, five patients (27.8%) had calcification. Surgical resection was performed in all patients. No studies reported recurrence after resection. Conclusion :The occurrence of posterior fossa teratomas in adulthood is difficult to diagnose at the initial stage. Radiographic diagnosis alone can lead to misdiagnosis. Pathological confirmation is essential. Surgical resection is a curative option for posterior fossa teratomas in adulthood.

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Section: Discussionmentioning

confidence: 99%

“…The occurrence of posterior fossa teratomas in adulthood is extremely rare. Only several cases have been reported thus far in the literature 1,[3][4][5][6][7][8]10,13,16,[18][19][20][21][22][23][24] . The prognosis and clinical, histological, and radiographic features of posterior fossa teratomas are unknown.…”

Section: Introductionmentioning

confidence: 99%

Posterior Fossa Teratomas in Adults : A Systematic Review

Shin

Kim

Song

et al. 2021

J Korean Neurosurg Soc

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“…found elements include fat, bone, cartilage, teeth, and hair. They have been reported to occur in the lateral ventricles, pineal region, suprasellar regions, and the posterior fossa, while teratomas arising within the fourth ventricle have been rarely reported [6][7][8][9][10][11][12]. Patients with these lesions typically present in the first two decades of life [9].…”

Section: Postoperative Coursementioning

confidence: 99%

“…They have been reported to occur in the lateral ventricles, pineal region, suprasellar regions, and the posterior fossa, while teratomas arising within the fourth ventricle have been rarely reported [6][7][8][9][10][11][12]. Patients with these lesions typically present in the first two decades of life [9]. For tumors originating in the pineal region, clinical presentation is usually that of hydrocephalus or Parinaud's Syndrome [13].…”

Section: Postoperative Coursementioning

confidence: 99%

“…In this case, we report a patient who presents with a ruptured intracranial teratoma originating from the fourth ventricle. Although well described in the pineal and suprasellar regions, infratentorial teratomas originating in the fourth ventricle have only rarely been described [6][7][8][9][10][11][12]. In 2010, Xuzhu et al reported a ruptured teratoma with a large posterior fossa component and a smaller suprasellar component after a patient presented with cranial nerve dysfunction [15].…”

Section: Postoperative Coursementioning

confidence: 99%

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Ruptured Intracranial Teratoma: A Case Report and Literature Review

Romero¹,

Chen

Guzmán³

et al. 2015

Clin Med Rev Case Rep

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Teratomas are germinal cell tumors originating from all three germ cell layers. When intracranial in location, they typically occur in the pineal or suprasellar regions. Ruptured intracranial teratomas are exceedingly rare. The authors report a case of a 34-year-old woman with a ruptured fourth ventricular mature teratoma that was treated with open surgery. The patient initially presented complaints of headache, nausea, and dizziness. CT scan demonstrated a mixed density lesion in the fourth ventricle and hypodensity lesions in bilateral lateral ventricles. MRI imaging revealed a complex fourth ventricular lesion and high T1 signal bilaterally in the lateral ventricles. A ruptured fourth ventricular teratoma was suspected and the patient was taken for surgery. Histopathology confirmed the diagnosis. Due to CSF leaking from her wound she ultimately underwent a ventriculoperitoneal shunt procedure several days later for persistent pseudomeningocele and hydrocephalus. A review of the literature is performed. Spontaneous rupture of intracranial mature teratomas is seldom encountered. The later atypical presentation may be attributed to the tumor's unusual location, precluding the more typical visual or endocrine abnormalities which may have otherwise resulted in an earlier diagnosis.

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Pineal mixed germ cell tumor with a synchronous sellar lesion in the sixth decade

et al. 2011

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Intracranial germ cell tumors (GCTs) typically affect children and adolescents. We here report on a 59-year-old male patient presenting with diplopia, polydipsia and polyuria. On clinical examination, slight restriction of the upward gaze was seen on the left side. Computed tomography demonstrated calcifications in the pineal region and enhanced neurohypophysis. Magnetic resonance imaging displayed a heterogeneous pineal mass of 3-cm diameter, which was multicystic with an enhanced cyst wall, and also swelling of the pituitary stalk. The pineal lesion of the tumor, which included calcifications and keratinaceous components, was totally excised using an occipital transtentorial approach. Histopathological examination showed it to be a mixed GCT with germinoma and mature teratoma components. Postoperative chemoradiotherapy provided complete disappearance of the suprasellar lesion. To our knowledge, this is the first case of mixed bifocal GCT in an older adult reported in the literature, although a few cases of tumors with a single histological component have been reported. Hence, our case further underlines the possibility of the occurrence of GCTs in older adults and advocates the consideration of GCTs in the differential diagnosis of such cases for appropriate management.

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Teratoma in the Fourth Ventricle of an Elderly Adult

Cited by 6 publications

References 7 publications

Posterior Fossa Teratomas in Adults : A Systematic Review

Posterior Fossa Teratomas in Adults : A Systematic Review

Ruptured Intracranial Teratoma: A Case Report and Literature Review

Pineal mixed germ cell tumor with a synchronous sellar lesion in the sixth decade

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