Unusual association of intraspinal extramedullary teratoma with congenital scoliosis in an elderly adult: case report and literature review.

INTRODUCTION: Intraspinal teratomas associated with congenital scoliosis are extremely rare, especially in an elderly adult. MATERIALS AND METHODS: We report the seventh case of intraspinal extramedullary teratoma coexisting with congenital scoliosis in a patient older than 50 years, possibly the oldest patient documented in literature. A 56-year-old male suffered from low back pain that increased with calf numbness and foot weakness. Conventional radiography showed a congenital scoliosis due to incomplete segmentation of the L2 and L4 vertebras, and magnetic resonance images revealed a heterogeneous intraspinal extramedullary mass located at L4-S1. RESULTS: The tumor was totally removed, and was confirmed as a mature teratoma on biopsy. The patient remains asymptomatic at 34-month follow-up. CONCLUSIONS: Rare intraspinal teratoma should be included in the differential diagnosis of intraspinal mass, especially in patient with congenital scoliosis. Patient with mature teratoma may survive with out any symptoms in the long term. Progressing neurological deficit is a main indication for surgery. Excellent clinical outcomes could be achieved by surgical resection and dural sac decompression.

Case Report: Review of CT Findings and Histopathological Characteristics of Primary Liver Carcinosarcoma.

Objectives: The aim of the present study was to describe the computed tomography (CT) characteristics of primary liver carcinosarcoma (PLCS) and to explore the pathological basis for the diagnosis of primary hepatocellular carcinoma sarcoma. Methods: Three male patients with PLCS were included in the present retrospective research, and the age was ranged from 52 to 63 years. The plain CT scan and third-stage enhancement scan were performed on patients. The pathological characteristics were analyzed. Stomachache was the main clinical symptoms of the three patients. Cirrhosis background was confirmed in one patients, and chronic Hepatitis B background was confirmed in other two patients. Results: According to the results of CT, the inner diameter of the tumors ranged from 8.6 to 27.0 cm. The fibrous pseudocapsule around the tumor tissues was observed in two patients. Tumor tissues from all three patients were composed of sarcomatous and carcinomatous components. For carcinomatous components, hepatocellular carcinoma was observed in one patient and cholangiocarcinoma was observed in the other two patients. For sarcomatous components, angiosarcoma was observed in two patients and malignant fibrous histiocytoma was observed in another one patient. The tumor tissues were visualized as heterogeneous low density with large sheets of necrotic cystic lesions or thick-walled areas of multilocular cystic lesions using the plain CT scan. Edge-to-center filling and strengthening lesions, mild to moderate enhanced parenchyma at the arterial phase, and isodensity between the tumor parenchyma and the surrounding liver parenchyma at the portal vein phase or delayed phase were observed using the third-stage enhancement scan. Conclusions: CT characteristics observed in the present study were of great benefit for the diagnosis of PLCS.