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Nephrogenic rest vs immature teratoma associated with lumbosacral lipomyelomeningocele: a case report and review of the literature

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Abstract

Background

Lipomyelomeningoceles (LMMs) are subcutaneous lipomas with dural penetration that often present with spinal cord tethering and may lead to neurological deterioration if untreated. This report describes a rare case of an LMM associated with immature nephroblastic tissue, representing a nephrogenic rest (NR) or, less likely, an immature teratoma.

Clinical presentation

An 8-day-old infant girl presented to the clinic with a sacral dimple. Imaging demonstrated a tethered spinal cord with low-lying conus medullaris and an LMM. A firm mass was noted in the subcutaneous lipoma. Detethering surgery and removal of the lipoma and mass were performed at the age of 6 months. Pathological examination identified the mass as cartilage, fat, and immature nephroblastic tissue consistent with NR tissue or, less likely, a teratoma with renal differentiation.

Conclusion

This presentation of an LMM associated with an immature teratoma or NR poses a risk of malignant transformation in patients. As a result, careful surgical dissection, resection, and close clinical follow-up are recommended for these patients.

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Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, AR, USA

    Meghana Bhimreddy, Nancy Abu-Bonsrah, Yuanxuan Xia, Adam Ammar & Alan R. Cohen

  2. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, AR, USA

    Pedram Argani

Authors
  1. Meghana Bhimreddy
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  2. Nancy Abu-Bonsrah
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  3. Yuanxuan Xia
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  4. Adam Ammar
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Contributions

Meghana Bhimreddy wrote the main manuscript text and prepared Figs. 1 and 2 and Table 1. Dr. Pedram Argani prepared Fig. 3. Dr. Alan Cohen provided images for Fig. 1. Meghana Bhimreddy, Dr. Nancy Abu-Bonsrah, Dr. Yuanxuan Xia, Dr. Adam Ammar, Dr. Pedram Argani, and Dr. Alan R. Cohen edited, reviewed, and approved the manuscript.

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Correspondence to Meghana Bhimreddy.

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Bhimreddy, M., Abu-Bonsrah, N., Xia, Y. et al. Nephrogenic rest vs immature teratoma associated with lumbosacral lipomyelomeningocele: a case report and review of the literature. Childs Nerv Syst 39, 1685–1689 (2023). https://doi.org/10.1007/s00381-023-05867-7

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