Intracranial teratomas in children: a clinicopathological study.

Introduction: Intracranial teratoma is a rare entity, accounting for 0.5 % of all intracranial tumors and 2-4 % of intracranial tumors in children.

Objective: To study the demographic profile, clinical, radiological, and histopathological features of pediatric intracranial teratomas.

Methods: All cases of intracranial teratoma diagnosed over an 11-year period (2001-2011) were retrieved from records of the departments of Neurosurgery and Neuropathology. Patients' demographic profile, clinical and radiological features and intraoperative findings were recorded.

Results: We identified 43 cases of CNS teratoma, which included 8 adults and 35 children. Of the pediatric cases, 23 were spinal in location. Twelve cases of pediatric intracranial teratoma were identified (eight males, four females). Eight occurred in the first decade and four in the second decade (age range 3 days to 16 years). Third ventricle was the most common site (six cases). Four cases were seen in association with occipital encephalocele. All patients underwent surgery except for a newborn, which died 3 days after birth and was autopsied. Histologically, eight cases were classified as mature teratomas and four as immature teratomas. All four cases of immature teratoma were located in the posterior third ventricle.

Conclusion: A diagnosis of teratoma should be considered in young children presenting with a solid-cystic tumor in the region of the posterior third ventricle. Teratomas located in the posterior third ventricle are more likely to have immature components. In view of the coexistence of teratoma with occipital encephalocele, thorough histopathological sampling of the excised sac and contents is advised.