Laparoscopic Surgical Management of a Gastric Dumbbell Teratoma

Abstract

Background: Teratomas are totipotent tumors commonly seen in gonadal and extragonadal region. Gastric teratomas are very rare and account for <1% of the cases. Conventionally, the treatment of gastric teratoma is open excision of the tumor. We present a rare variant of a gastric teratoma managed laparoscopically. Clinical Description: An 8 months' old male was noted to have pallor and history of blood-tinged spit-ups. The child was worked up for the cause of anemia with an upper gastrointestinal disorder as the first differential. The child had significant anemia with a hemoglobin level of 6 g/dl and was transfused packed red blood cells sequential imaging with an abdominal ultrasound, contrast-enhanced computerized tomographic scan, and magnetic resonance imaging identified the presence of a gastric teratoma with both an intragastric and extragastric component (dumbbell variant). He was referred to the pediatric surgery services for further management. Management: The infant underwent a gastroscopy to further define the intragastric component of the mass. This revealed a sessile submucosal polypoidal lesion with multiple areas of erosions in the region of the fundus. A biopsy from this suggested a teratoma. The child underwent a total laparoscopic excision of the lesion and recovered well. The histopathology of the tumor was consistent with a mature cystic teratoma (Grade 0). The postoperative period was uneventful. Conclusion: Laparoscopic complete surgical excision of the dumbbell variant of gastric teratoma in this child was curative, reduced morbidity, and hospital stay compared to usual open surgery.