Extensive epidural teratoma in early infancy treated by multi-stage surgery

We report a rare case of extensive extradural teratoma successfully treated by multi-stage laminotomy and thoracotomy. A 34-day-old, dyspneic infant h ad a large posterior mediastinal mass identified on a chest X-ray radiograp hy. Imaging studies disclosed that the mass originated from the extradural space at the level of the lower thoracic spine, extending cephalad to C4 an d caudad to L4 and severely compressing the spinal cord anteriorly, causing paraplegia. The tumor expanded bilaterally through the intraspinal foramin a, coalescing to form a huge mediastinal mass. The upper half of the terato ma was removed utilizing a laminotomy from T3 through T9; 2 months later th e lower half was excised via a laminotomy from T11 to L3. An additional pro cedure was required to resect recurrent tumor through a laminotomy from T8 to T12. The reconstructed vertebral arches were well-preserved in shape, wi th an almost normal spinal canal.