BACKGROUND: Intramedullary tumors affect a small but significant portion of patients with spinal tumors. Ependymomas and astrocytomas are the most common entities. The diagnosis of a mature teratoma is extremely rare, although not in the presence of associated developmental abnormalities. The medullary conus is the most common location. Such a case with caudal exophytic growth is presented here and the literature extensively reviewed. CASE PRESENTATION: Low back pain and muscle weakness led to diagnosis of a exophytic intramedullary lesion of the conus medullaris in a 52-year-old woman. After subtotal resection the symptomatology partially improved. Histopathological examination revealed mature teratoma. CONCLUSION: Literature review identified 68 cases of intramedullary teratomas. These should be considered in the differential diagnosis when an associated developmental abnormality is present. Subtotal resection is a valid alternative to radical tumor removal when neurological function is at risk. The prognosis of adult patients with intramedullary mature teratoma is excellent. Georg Thieme Verlag KG Stuttgart New York.

Department of Neurosurgery Regional Hospital Liberec Husova 10 Liberec 46063 Czech Republic