Hello. My name is Jack Henry, DC, DACBR. I am Radiologist-in-Chief of
Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses. All of our services are provided at no cost to doctor and no/low cost to patients.
Selected cases will be presented for your evaluation. The studies may or may not have abnormalities. Use the arrow keys or the scroll bar to carefully evaluate the films.
Step 1: Is the study abnormal or normal?
Step 2: If the study is abnormal, what is your best diagnosis?
Step 3: Which follow-up imaging option would be best?
Step 4: Compare your results with the correct diagnosis.
HISTORY
A 39-year-old female reports low back pain after shoveling snow. The patient’s past medical history was not provided. Physical examination was unremarkable.
FINDINGS
The study is negative for acute fracture or dislocation. No evidence of significant degenerative change is present. Rudimentary ribs are present and the S1 segment is transitional in nature. Please note the mass density projected over the pelvic basin on the frontal and lateral images. The densities visualized are reminiscent of teeth.
DISCUSSION
What are we looking at? And, what should we do next? This tumor represents a teratoma and is considered a germ cell tumor. Teratomas are usually encapsulated and may contain mature structures like an eye, bone, hair, hands, feet, or as with this example, teeth.
FOLLOW UP PROTOCOL
If clinically warranted, mature teratomas may be surgically resected. Malignant transformation is extremely rare.