‘Evil twin’ cause of woman’s brain tumor

Chuck Bednar for redOrbit.com – @BednarChuck

Odds are, most people at one point in their childhood blamed their “evil twin” when something went wrong or was broken. But as it turns out, doctors recently discovered an Indiana woman’s brain tumor actually was caused by an “evil twin”…sort of.

As Discovery News reported, 26-year-old Yamini Karanam recently underwent brain surgery in Los Angeles after reporting difficulty comprehending things that she had read or been told; and when doctors opened her up, they found a brain tumor that contained hair, teeth, and bone.

While the tumor was dubbed an “embryonic twin,” it actually wasn’t an embryo or a twin; it was a teratoma, a tumor that may contain three major cell types found in early-stage, developing human embryos, the website said.

Not as uncommon as one might think

NBC Los Angeles called it “a twist worthy of a sci-fi plot,” but Dr. Amir Dehdashti, director of cerebrovascular neurosurgery research at North Shore University Hospital in New York, and Dr. Cathy Burnweit, chief of pediatric surgery at Miami’s Nicklaus Children’s Hospital, explained to Discovery News that teratomas themselves are not all that rare.

Teratomas, which can even contain tissue from lung, muscles and the gastrointestinal tract, occur when germ cells that are supposed to migrate to the gonads during embryonic development wind up going to the wrong place. They most frequently occur in the ovaries, testes and tailbone, the website noted, and Dr. Burnweit said she treats at least one ovarian teratoma per month.

Brain teratomas are relatively rare in comparison, according to Dr. Dehdashti. Only 0.5 percent to 3.0 percent of brain tumors are germ cell tumors, and only one-fifth of those are teratomas. Still, he said, “This is not something totally unknown to neurosurgeons,” adding that he had encountered three or four such tumors over the course of his career.

The tumors tend to be benign, rarely spread to other parts of the body, and post-treatment survival rates are high.

Using keyhole surgery to remove the “evil twin”

Karanam, a Ph. D. student at Indiana University, explained to NBC Los Angeles that she first noticed something was amiss last September, but became frustrated because the doctors she consulted could not agree on the possible cause of her comprehension problems. She decided to conduct her own research, and found Dr. Hrayr Shahinian at the LA-based Skullbase Institute.

Dr. Shahinian had come up with a minimally-invasive method of reaching deep into the brain to extract tumors, the news outlet explained. Instead of opening the skull and using metal retractors as in traditional brain surgery, his technique uses fiber-optic technology and digital imagery to see the inside of the brain. The keyhole procedure requires just a one-half inch incision into the brain, and the use of an endoscope to slowly and carefully remove the tumor.

Dr. Shahinian said he had taken out at least 7,000 brain tumors, but that this was just the second teratoma he had encountered. Karanam woke up after surgery and joked that the tumor was her “evil twin sister who’s been torturing me for the past 26 years”, and despite initial fears that the tumor could be cancerous, Karanam is expected to fully recover in just a few weeks.

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