• Karam Asmaro, Mohamed Abouelleil, Sameah Haider, Hesham Mostafa Zakaria, Ciprian Gradinaru, Abir Mukherjee, and Ian Lee.
• Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA. Electronic address: kasmaro2@hfhs.org.
• World Neurosurg. 2019 Jul 1; 127: 15-19.

BackgroundIntraspinal dermoid tumors are usually rare benign growths that occur as a result of defects during neural tube formation. They make up less than 1% of tumors in the spine and are associated with spinal dysraphisms or sinus tracts. Although rare, malignant transformation into squamous cell carcinoma has been previously reported. Malignant transformation into adenocarcinoma, however, represents a novel phenotypic differentiation pattern that is hitherto undescribed.Case DescriptionA 45-year-old woman presented with acute symptoms of cauda equina syndrome. Imaging of the spine revealed a large intradural sacral mass. The lesion was surgically resected with pathology revealing a dermoid tumor with malignant transformation into adenocarcinoma. Metastatic workup revealed no other suspicious lesions. The patient had an uneventful postoperative course, gradually regaining micturition control.ConclusionsDermoid tumors, also known as benign cystic teratoma or mature teratoma, are usually benign congenital tumors comprising epithelial cells that arise from displaced embryonic ectoderm and mesoderm during neural tube formation. Although extremely rare, malignant transformation into squamous cell carcinoma has been reported. This case represents the first report of an intraspinal dermoid tumor transforming into adenocarcinoma. A comprehensive histopathologic analysis is key to identifying the lesion and guiding postsurgical management.Copyright © 2019 Elsevier Inc. All rights reserved.

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