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Maryland doctors extract teeth from rare brain tumor in 4-months old infant

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An infant boy who once had teeth growing inside his brain is now doing extremely well after doctors performed a surgery to extract the teeth.

The four month-old baby's head was growing much more rapidly than normal, so his doctors gave him an MRI scan, which revealed a tumor that was 4.1 cm by 4 cm by 3.5 cm. The MRI showed that the tumor contained structures which looked very much like the teeth that the boy had in his lower jaw.

Surgery was then conducted to remove the tumor in his brain, and doctors found that the tumor did contain several fully-formed teeth. The mass was identified as adamantinomatous craniopharyngioma, a slow-growing tumor that can grow to be larger than a golf ball but does not spread outside of the brain. It is believed to grow from the Rathke's pouch, which is the embryonic precursor to the pituitary gland.

The report of the finding was published in the New England Journal of Medicine.

There have been cases of craniopharyngioma before, and medical professionals and researchers believe that the tumors form from the same cells that are responsible for forming teeth, but this is the very first time that doctors have actually seen teeth inside a craniopharyngioma tumor.

"It's not every day you see teeth in any type of tumor in the brain. In a craniopharyngioma, it's unheard of," said Dr. Narlin Beaty, a neurosurgeon at the University of Maryland Medical Center, who performed the boy's surgery along with his colleague, Dr. Edward Ahn, of Johns Hopkins Children's Center.

With this case, medical researchers now have additional evidence that both craniopharyngiomas and teeth indeed form from the same cells. The teeth have been sent to a pathologist for further study, and will be saved for many years to come, in case more study is needed.

There have been reported cases of teeth found in tumors, but these have occurred only in teratomas, which contain all three types of tissue found in an early-stage human embryo. Craniopharyngiomas, on the other hand, have only one layer of tissue, but since they are tumors of the pituitary gland, which controls the release of important hormones, the tumors end up causing a lot of problems.

In the case of the four month-old baby with the teeth in his craniopharyngioma, the normal connections in the brain that controlled the release of hormones were destroyed. As a result, he would need to receive hormone treatments for the rest of his life. However, his doctors said he is doing very well.

"In the year since he underwent surgery, the patient has required shunting for bilateral subdural hygromas and receives thyroid and adrenal hormone-replacement therapy. He is making good developmental progress, and as part of his follow-up, he currently undergoes routine MRI," the report concluded.

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