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case study: baby's brain tumour had fully formed teeth

type of tumour that forms from teeth shows up in four-month-old.

case study: baby's brain tumour had full formed teeth
doctors made an unusual discovery when removing an infant's tumour. getty
the only thing that could be worse than learning your newborn has a brain tumour is hearing the doctor tell you the abnormality is literally sinking its teeth in.

that was the frightening reality facing the parents of a four-month-old baby in maryland after doctors noticed the child’s head was growing more quickly than normal, according to live science . brain scans soon revealed the tumour, located near the pituitary gland, contained structures that closely resembled the pearly whites more commonly connected to the lower jaw in humans.

“it always has been hypothesized that this type of tumour is from cells that form teeth,” said narlin beaty , the attending neurosurgeon at the university of maryland medical center . “we see calcification and keratin and other parts of teeth, but very rarely do we see fully formed teeth. any time you see anything out of the ordinary in medicine, it is important to document it and learn from it.”

so, rather than grin and bear it, beaty and his colleagues quickly got to work removing the tumour and discovered, to their amazement, that it contained several fully formed baby chiclets. further analysis, detailed in the new england journal of medicine , revealed the formation to be a craniopharyngioma , a rare, benign tumour that can grow as big as a golf ball.

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while the medical community had long suspected that craniopharyngiomas form from the same cells that produce teeth, and that many such tumours contain calcium deposits, “when we pulled out a full tooth… i think that’s something slightly different,” beaty said.

this wasn’t the first time an oral anomaly was detected in the human brain but the strange development usually only bares its teeth in tumours known as teratomas, which contain all three types of tissues normally present in the early development of an embryo. doctors have found all sorts of bodily structures within teratomas — including fingers and even partially formed humans, according to james rutka , a pediatric neurosurgeon and chair of the university of toronto’s department of surgery. craniopharyngiomas, on the other hand, contain just one layer of tissue.

although the noncancerous growths can occur at any age, according to the mayo clinic , they most commonly develop in children and older adults. aside from being a real nightmare for the tooth fairy, the slow-growing tumours can interfere with the proper functioning of the pituitary gland — which controls vital hormone levels in the body — and other structures of the brain. symptoms typically include fatigue, changes in vision, headaches and excessive urination and surgery is generally recommended to remove as much of the tumour as possible without damaging the surrounding structures of the brain, as was the case in the four-month-old in this study.

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the operation, while successful, revealed that the tumour had irreparably damaged the baby’s pituitary gland, meaning he will require hormone treatments for the rest of his life — a small price to pay to save one’s brain from the jaws of certain death.
“he’s doing extremely well, all things considered,” beaty said. “this was a big tumour right in the center of his brain. before the modern surgical era, this child would not have survived.”
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dave yasvinski is a writer with  healthing.ca

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