Conus medullaris teratoma in an adult: A case report and literature review

Spinal teratomas arise from embryonic germ cells. The present case report describes a 54‑year‑old male patient with recurrent low back pain accompanied by radiating pain and numbness in the left lower limb for >1 month. CT and MRI revealed an irregular lesion in the conus medullaris. Gross total resection was achieved, with histopathological examination determining an intramedullary mature teratoma (IMMT). No new postoperative neurological deficits occurred. At the final outpatient follow‑up, ~4 months after surgery, the lower back pain and radiating pain had markedly improved, although mild numbness persisted in the left lower limb. Adult conus medullaris IMMTs are rare and prone to preoperative misdiagnosis due to their unusual location and heterogeneous imaging appearance. To improve recognition of these tumors, the present report describes the clinical, imaging and pathological features of the present case and briefly reviews similar cases. The combined presence of calcification, focal fat, cystic components and heterogeneous enhancement may prompt the consideration of IMMT in the differential diagnosis of conus medullaris lesions and reduce the risk of diagnostic error.