Gastric teratoma in children: Our experience

Abstract

Summary Background/Introduction Gastric teratoma is an extremely rare tumor, almost exclusively benign, accounting for Purpose/Aim This work aimed to study the clinical presentation, investigation modalities, intraoperative findings, histopathological types, and surgical outcome of gastric teratoma in children. Methods A retrospective study was performed from 1993 to 2013 in two pediatric institutes. Results There were eight patients with gastric teratoma and all of them were male. Seven (87.5%) patients presented in infancy, out of which four (50%) patients were neonates, while one (12.5%) patient was a toddler. The manifestations were as follows: a palpable abdominal mass in seven (87.5%), abdominal distension in five (67.5%), anemia in four (50%), respiratory distress in three (37.5%), gastric outlet obstruction with recurrent vomiting in three (37.5%), and abdominal pain, anorexia, and melena in one (12.5%) each. Ultrasonography showed a solid cystic mass with mixed echogenicity in all the patients, while calcification was seen in seven (87.5%) cases. Computed tomography, which was performed in four (50%) patients, clinched the preoperative diagnosis. A growth was present on the posteroinferior wall near the greater curvature in seven (87.5%) cases, while in one (12.5%) patient, it was arising from the lesser curvature. Excision of the tumor was performed in all patients. Histopathology was mature type in six (75%) cases, and immature Grade 1 and 2 in one (12.5%) each. Complications were seen in five (62.5%) cases, and one (12.5%) mortality was observed in our series. All other patients were doing well in the postoperative period. Conclusion Gastric teratoma is almost always benign and has predilection for male sex. It commonly presents as a palpable abdominal mass. Complete surgical excision is curative. Close observation is recommended for Grade 2 and 3 immature teratomas. The prognosis is excellent.