Teratoma maduro del filum terminale. Extirpación guiada por estimulación directa de raíces nerviosas / Mature filum terminale teratoma. Excision guided by direct stimulation of nerve roots

Varón de 45 años, sin antecedentes de interés, que acudió a urgencias con cuadro progresivo de pérdida de fuerza en miembros inferiores a nivel distal con imposibilidad para la flexión dorsal del pie izquierdo, acompañado de disfunción neurógena de vejiga. En la RM se objetivó una lesión a nivel del filum terminale que interesaba completamente el diámetro transversal del saco dural, siendo la impresión diagnóstica radiológica de lipoma del filum terminale. Se llevó a cabo cirugía con monitorización neurofisiológica intraoperatoria empleando estimulación directa de raíces nerviosas, lo que permitió la extirpación de una tumoración compuesta por material sebáceo, grasa y pelo. El diagnóstico anatomopatológico fue de teratoma quístico maduro. El paciente presentó evolución postoperatoria favorable (AU)

A 45-year-old male patient, with no history of interest, consulted in emergency department due to a progressive loss of strength in the lower limbs at the distal level with impossibility for dorsal flexion of the left foot, as well as neurogenic bladder. The MRI revealed a mass at the filum terminale with completed occupation of transverse diameter of the dural sac. The radiological diagnosis was lipoma of filum terminale. The patient underwent surgery with intraoperative neurophysiological monitoring using direct stimulation of nerve roots, which allowed the removal of a tumour composed of sebaceous material, fat and hair. The anatomopathological study classified it as a mature cystic teratoma. Postoperative evolution was favorable (AU)

Mature filum terminale teratoma. Excision guided by direct stimulation of nerve roots. / Teratoma maduro del filum terminale. Extirpación guiada por estimulación directa de raíces nerviosas.

A 45-year-old male patient, with no history of interest, consulted in emergency department due to a progressive loss of strength in the lower limbs at the distal level with impossibility for dorsal flexion of the left foot, as well as neurogenic bladder. The MRI revealed a mass at the filum terminale with completed occupation of transverse diameter of the dural sac. The radiological diagnosis was lipoma of filum terminale. The patient underwent surgery with intraoperative neurophysiological monitoring using direct stimulation of nerve roots, which allowed the removal of a tumour composed of sebaceous material, fat and hair. The anatomopathological study classified it as a mature cystic teratoma. Postoperative evolution was favorable.