Composite split cord malformation coexisting with spinal cord teratoma - case report and review of the literature

The coincidence of split cord malformation (SCM) and intraspinal teratoma is an extremely uncommon condition. We report a case of a neurologically asymptomatic 13-year-old girl with a 5-year history of progressive scoliosis. The routinely performed MRI revealed SCM at levels L1-L2, tethering of the spinal cord at levels L4-L5 and the presence of an intraspinal tumour at the level of the observed SCM. Intraoperative investigation revealed composite character of SCM. The hemicords were separated by an osseo-cartilaginous septum and contained in a single dural tube. We claim that this is the second described case of a composite SCM and an intraspinal teratoma coexisting at the same level. This case supports the idea that scoliosis may be accompanied by congenital spinal cord anomalies like SCM and intradural tumours. MRI should be the basic diagnostic investigation in such cases. Scoliosis coexisting with SCM and an intradural tumour requires complex neurosurgical and orthopaedic treatment.