Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Case Report Pediatr Neurosurg 2010;46:368–372 DOI: 10.1159/000321802 Complex Split Cord Malformation with Mediastinal Extension of a Teratoma and Simultaneous Ventral and Dorsal Bony Spur Splitting the Cord Vikas Naik   a Ashok Kumar Mahapatra   a Chaitali Gupta   b Vaishali Suri   b a  Department of Neurosurgery and Gamma Knife Centre and b  Department of Neuropathology, All India Institute of Medical Sciences, New Delhi, India reported from our institute in 2006. This is the first report of its kind of simultaneous dorsal and ventral bony spur at the same level. Copyright © 2011 S. Karger AG, Basel Introduction Teratomas are rare spinal cord tumours with only iso- lated case reports [1, 2]. There are only 2 series describing spinal teratomas [1–3]. Their association with split cord malformation is very rare, with only 19 case reports till date. There are only 2 case reports describing a primary intradural spinal teratoma extending into the mediasti- num to the best of the authors’ knowledge. Another unique feature in our case is the simultaneous coexis- tence of both ventral and dorsal bony spurs at the same level. Case Report A 2-year-old male child presented to us with dorsal dermal sinus and kyphosis. He had no history of weakness of limbs or change in bowel and bladder habits. There was no orthopaedic deformity except for kyphosis. The developmental milestones Key Words Type I split cord malformation  Spinal teratoma  Mediastinal extension  Dorsal and ventral bony spurs Abstract Introduction: Association of split cord malformation with teratoma is an extremely rare condition. It is very unusual to find split cord malformation with teratomas extending into the posterior mediastinum and still rarer to find bony spur arising dorsally and ventrally at the same level. Case Report: The authors describe the case of a 2-year-old child who pre- sented with dorsal kyphosis and a dermal sinus. The neuro- logical examination was unremarkable. MRI and noncon- trast CT of the spine revealed Pang’s type I split cord malfor- mation at the D9–12 level. Bony spur was seen arising both dorsally and ventrally at the D9–12 level. Intraoperatively, in- tradural teratoma was found coming extradurally both pos- teriorly between the 2 spurs and anteriorly into the posterior mediastinum above the bony spurs through a defect in the vertebral body of 2 cm diameter. Near total excision was per- formed. Discussion: To the best of the authors’ knowledge, this is the second case report of an intradural teratoma ex- tending into the mediastinum, occurring with split cord mal- formations and other spinal anomalies. A similar case was Received: May 20, 2010 Accepted: October 4, 2010 Published online: March 9, 2011 Vikas Naik Department of Neurosurgery and Gamma Knife Centre All India Institute of Medical Sciences New Delhi 110029 (India) Tel. +91011 2658 3291, Fax +91011 2658 9650, E-Mail vikasnaik007  @  yahoo.co.in © 2011 S. Karger AG, Basel 1016–2291/10/0465–0368$26.00/0 Accessible online at: www.karger.com/pne