Gastric teratomas in paediatric population: A case series from a tertiary care centre of Northern India

Abstract

A retrospective analysis of all paediatric patients diagnosed and treated for gastric teratomas in our hospital over the past 20 years was carried out (1997–2017). A database of the clinic-pathological characteristics of these patients was developed. In all, 7 patients were identified. All the patients underwent resection and were followed up every 6 months. The investigations performed included routine blood investigations, X-ray, alpha fetoproteins (AFP), beta HCG levels and a CT scan of the abdomen. There were seven patients with gastric teratomas and all of them were male except one female. Their ages ranged from 1 day to 4 years. Six (85.7%) patients presented during infancy. The manifestations were as follows: a palpable abdominal mass followed by anemia, respiratory distress, abdominal distension, gastric outlet obstruction with recurrent vomiting, and abdominal pain, anorexia, and melena. Histopathology was mature type in five (71.4%) cases, and immature Grades 1 and 2 in one (14.2%) each. Complications were seen in four (57.1%) cases, and there was one (14.2%) mortality in our series. Recurrence was seen in two of our cases. The preoperative diagnosis of Gastric teratoma may be challenging, but with recent advances in imaging an accurate diagnosis and staging is possible. Complete surgical excision is curative in all cases, with close observation and follow-up. • Gastric teratoma is an exceptionally rare embryonic neoplasm occurring in neonatal period and infancy. • Due to the paucity of the number of cases, the natural history of the disease is not fully understood and its preoperative diagnosis remains elusive. • Complete surgical excision is curative in all cases, with close observation and follow-up being recommended in Grade 2 and 3 immature teratomas. • The detection of immature component carries a prognostic implication and hence, extensive sampling is essential. • Postoperatively, the prognosis is excellent. • Long term follow-up with AFP and beta hCG depending on the type is the standard protocol to be adopted.