Surgical management of cerebellopontine angle teratomas with total and subtotal approach in adults: A case report.

Abstract

Introduction: Germ cell tumors (GCTs) are neoplasms originating from either gonadal or extragonadal tissues. Primary central nervous system (CNS) GCTs are rare and categorized into germinomas and non-germinomatous germ cell tumors (NGGCTs), the latter including teratomas. Intracranial teratomas represent a small fraction (0.1-1.5 %) of all brain tumors, predominantly occurring in the pineal and sellar regions. Posterior fossa teratomas in adults are exceptionally rare.

Case presentations: This study presents two cases of cerebellopontine angle (CPA) mature teratomas in adult patients. The first case involves a 26-year-old female with severe headaches, diagnosed via MRI with a left CPA mass extending to the C2 level, confirmed as a mature teratoma post-surgical resection. The second case features a 37-year-old male with an incidental finding of a right CPA mass, leading to subtotal resection due to proximity to critical brainstem structures.

Discussion: CNS teratomas constitute 0.5-1 % of intracranial neoplasms.Typical locations include midline structures; however, CPA localization is rare. Diagnosis primarily relies on imaging modalities like MRI, supplemented by histopathological confirmation. Surgical resection remains the mainstay of treatment, with the extent of resection balancing tumor removal and preservation of neurological function.

Conclusion: CPA teratomas are rare but should be considered in the differential diagnosis of CPA masses. Effective management requires advanced imaging for accurate diagnosis and careful surgical planning to balance tumor removal with preservation of neurological function. These cases illustrate successful outcomes with tailored approaches, emphasizing the need for awareness and expertise in handling such uncommon tumors.