Case Of Teratoma Research Articles

Collision Tumors in Ovary: Case Series and Literature Review

Histologically distinct tumors that coexist in an organ without any histological admixture at their interface are denominated collision tumors. We report 3 cases of colliding mature cystic teratoma with mucinous cystadenoma and a case of mature cystic teratoma colliding with benign Brenner tumor in the ovary. We also provide a literature review based on 35 previously published ovarian collision cases. Ovarian tumors from all classes, benign, borderline and malignant lesions may collide. Both our case series and the literature review indicate that ovarian tumor collisions tend to be clinically and ultrasonographically/radiologically unrecognized. The awareness among surgeons, radiologists and pathologists of this rare phenomenon and histological recognition are crucial in order to offer adequate treatment to patients. There is a need to identify novel and more specific imaging clues pointing towards collision tumors in the ovary.

Umbilical Cord Teratomas Associated With Congenital Malformations.

Congenital mature teratomas of the umbilical cord are extremely rare and pose a challenge in prenatal diagnosis. Mature teratomas are defined as tumors composed of mature tissues derived from more than 1 germ cell layer. The tumor often shows solid and cystic components, which adds to the difficulty of prenatal diagnosis. Although benign, mature teratomas of the umbilical cord are commonly associated with congenital malformations of the fetus with variable severity and rarely, with chromosomal abnormalities. To review the clinical, radiologic, gross, and histologic features of umbilical cord teratoma; its differential diagnosis; and to emphasize the increased risk of associated congenital malformations. Umbilical cord teratoma cases published in the literature. Umbilical cord teratomas are difficult to diagnose by imaging studies alone and require histopathologic examination for diagnosis. Given the increased risk of associated anomalies and malformations, the finding of umbilical cord teratoma should trigger a detailed and comprehensive evaluation of the neonate for additional abnormalities.

Clinical and Computed Tomography Features of Female Pelvic Malignant Germ Cell Tumors in Children and Adolescents: ASeries of 30 Cases.

To investigate the clinical features and computed tomography (CT) findings of malignant pelvic germ cell tumors in female patients and improve the diagnostic level of this disease. The clinical and CT data of 30 female patients with malignant pelvic germ cell tumors confirmed using histopathology were retrospectively analyzed, before surgery, at a tertiary hospital. Patient's age, tumor location, clinical symptoms, tumor marker levels, and CT findings were recorded. None. Identification of the clinical features and CT findings of malignant pelvic germ cell tumors. The patients ranged in age from 11months to 22years old, with a mean age of 12.3years. The 30 cases (30 tumors) included 10 cases of yolk sac tumor, 8 cases of dysgerminoma, and 5 cases of immature teratoma. The alpha-fetoprotein levels were elevated in 8 cases of yolk sac tumor. Eight cases of dysgerminoma showed lobulation sign. Four cases of immature teratoma contained fat and calcification. The fibrovascular septa were observed on contrast-enhanced CT images in 4 cases of dysgerminoma. The "bright dot sign" was noted on contrast enhanced CT images in 9 cases of yolk sac tumor. Remarkable enhancement of the solid component or septa was detected in 10 cases of yolk sac tumor. Obvious enhancement surrounding vascular bundles in the tumor was observed in 5 cases of dysgerminoma. Malignant pelvic germ cell tumors in female patients frequently affect children and adolescents. The CT findings of dysgerminoma, immature teratoma, and yolk sac tumor have certain characteristic features. The combination of CT manifestations, tumor markers, and patient age helps improve the diagnostic level of this disease.

1734 Resection of a Retroperitoneal Mature Teratoma Causing Severe Urinary Symptoms

Video Objective The objective of this video is to depict a robotic assisted laparoscopic resection of a retroperitoneal mass, showing a unique case where compression on the pelvic splanchnic nerves produced severe urinary symptoms in a patient which resolved immediately after the procedure. It also shows a rare case of extraogonadal retroperitoneal mature teratoma. Setting The patient is a 28 yo G1P1 who presented to care for worsening left lower quadrant pain and pressure, urinary frequency, urgency and hourly nocturia. History is significant for dysmenorrhea, abdominoplasty and acne taking spironolactone. Imaging revealed a mildly complex mass in the cul-de-sac measuring 10.6 × 8.3 × 7.3 cm, without thickening or nodularity, probably cystic and arising from the left ovary. She underwent laparoscopy for planned excision which was aborted as a retroperitoneal mass was identified involving the cul-de-sac and left pelvic sidewall without involvement of the ovaries, fallopian tubes and uterus. She was then referred to Gynecologic Oncology, Neurosurgery and then by Urogynecology. Interventions She underwent a robotic assisted laparoscopic removal of the left retroperitoneal mass with care to avoid use of excessive cautery, excision of endometriosis, left ureterolysis, enterolysis, peritoneal biopsy and cystoscopy with a intraoperative left ureteral stent placed by Urology, removed at the end of the case. After removal of the mass her urinary symptoms and pelvic pain completely resolved. Her postoperative course was uncomplicated. Pathologic findings of the retroperitoneal mass were consistent with a mature teratoma. Conclusion The retroperitoneal teratoma compressed the inferior hypogastric plexus which led to the patient's symptoms. Careful dissection of the pararectal and paravesical space was performed to cause minimal damage to the inferior hypogastric plexus and surrounding nerves with complete resolution of symptoms. Limited use of electrocautery was employed to avoid thermal damage. Extragonadal teratoma is a rare finding.

Bilateral adrenal teratomas

Abstract Teratoma is a rare type of germ cell neoplasm (GCN) which has an incidence of 0.9/100,000. These tumours occur more frequently in girls than in boys, and they usually are diagnosed before four years of age, with a mean age of 18 months. About 75% of these lesions are benign teratomas. Teratomas usually occur in the ovaries and testes, and less commonly in anterior mediastinum, retroperitoneum, sacrococcygeal region, and intestine. Primary adrenal teratomas are extremely rare, with only 18 cases of primary adrenal teratoma previously reported and only three paediatric cases (youngest age 1 day old). The management of adrenal teratoma is surgical resection. Surgery for mature adrenal teratomas is thought to be curative, but follow-up to monitor reoccurrence is warranted as long-term data are very limited. Bilateral adrenal teratoma has never been reported in the literature. We report a case on a two-year-old boy with bilateral mature adrenal teratoma who underwent successful surgical resections and summarise the related literature.

EP16.24: Prenatal diagnosis of a rare case of immature teratoma in the eye

EP16.24: Prenatal diagnosis of a rare case of immature teratoma in the eye

Huge mediastinal teratoma in children: anesthesiological approach, surgical strategy and literature review

Teratomas of the anterior mediastinum are infrequent germ cell tumour. These tumours occur at all ages, but are rarely discovered before puberty. We report a case of anterior mediastinal mature teratoma in a baby girl aged 5 months who presented to us with recurrent infectious pneumonia associated with hemoptysis since one month. Computed tomographic scan of thorax revealed a large anterior mediastinal mass measuring 8.01×6.72×7.28 cm 3 with calcification within. The authors report this current case to emphasize the importance of the multidisciplinary care and perioperative approach between anaesthesiologist and surgeon to a successful management of a huge mediastinal mature teratoma in an infant. Tips, tricks and pitfalls are proposed in this paper for a surgical outcome effective and no clinical complication.

Dual pathology a case report of yolk sac component in mature gastric teratoma

Gastric teratoma is a rare tumour accounting for less than 1% of all teratomas in pediatric age groups. We present a case of gastric teratoma in 33-month-old male infant who presented with abdominal pain for 2 months. Ultrasound of abdomen revealed a multi-cystic mass with mixed echogenicity arising from the lesser curvature of stomach. The mass was excised completely and sent for histopathological examination. Histopathology confirmed mixed germ cell tumour (gastric mature teratoma and yolk sac tumour). Serum AFP (alpha fetoprotein) and extensive sampling of the lesions can help in identification of other germ cell component. Keywords: Teratoma, Alpha fetoprotein, Yolk sac tumour.

DIAGNOSIS OF GERM CELL TUMORS OF EXTRAGONADAL LOCALIZATION IN TERMS OF ALGORITHMS FOR DETECTING METASTASIS OF CARCINOMAS OF UNKNOWN PRIMARY LOCALIZATION

The analysis of cases of extragonadal teratomas makes it clear that tumours derived from germ cells and mainly characteristic of adult gonads can also occur in other areas, such as the anterior mediastinum (thymus) and midline brain (germinomas of the epiphysis and the area above the Turkish saddle), that requires differential diagnosis with metastases of carcinomas of other origin. Accurate diagnosis of estrogenic germ-cell tumours by only routine staining with haematoxylin-eosin requires high expertise and experience due to their non-specific clinical symptoms and variability of morphological characteristics. Tumour morphologists consider that immunohistochemical investigation plays an important role in accurate histological diagnosis of these tumours. The goal of this study is to explore the expression features of immunohistochemical markers and morphometric parameters of the area, perimeter and "roundness" of the nuclei in various types of extragonadal germ-cell tumours compared to similar primary ovarian / testicular tumours in order to improve diagnostic algorithms. A study was conducted on biopsy or postoperative samples taken from 8 patients (group 1) with extragonadal germ-cell tumours and from 16 patients with primary germ cell tumours of testicles / ovaries (group 2). The diagnoses were confirmed by immunohistochemical investigation on the basis of the pathologic department of the “Pharmacy of Medical Academy” Diagnostic Centre for 2015 to 2018. PLAP and CD117 had the highest percentage of expression in seminomas and gerninomas of both studied groups; morphological parameters were 3-fold higher in area and ̴2-fold higher around the perimeter then the values of normal lymphocytes (p<0.05). Expression of markers CD30, EMA and CK AE1/3 was diagnostically significant in samples of embryonic carcinoma, and morphological parameters ̴were ̴ 2.1 times higher in area and ̴ 1.7 along the perimeter that exceeded the values of normal lymphocytes (p<0.05). αFP-positive staining was indicative of yolk sac tumours, which morphological parameters were more than ̴ 1.7 times higher in the area and ̴ 1.5 times higher along the perimeter compared with the normal lymphocytes (p<0.05). Taking into account the variability of morphological characteristics and the possibility of extragonadal location of tumours derived from germ cells, immunohistochemical research supported by morphometry is an important tool in the differential diagnosis of carcinomas of unknown primary localization.

Effects of mature cystic teratoma on reproductive health and malignant transformation: A retrospective analysis of 80 cases

Objective:To examine cases of mature cystic teratoma (MCT) that were diagnosed and treated in our clinic regarding their association with fertility, and to detect the rate of malignant degeneration and the types of malignancies.Material and Methods:Patients who underwent surgery due to adnexal mass between April 2012 and August 2017 and were diagnosed as having MCT were retrospectively examined. The mean age of the 80 patients who met the inclusion criteria was 30.60±10.5 years. Nine had infertility according to hospital records. Sixty-seven percent of these (n=6) had accompanying endometriosis and MCT was bilateral in 55.5% (n=5). Malignant degeneration was present in 6.25% (n=5), all were monodermal tumors. Malignant degeneration was more common among patients with larger diameter adnexal masses (9.1±2.9 cm) and in those of postmenopausal age. Tumor markers were within the normal range for patients who developed malignancy. Malignant degeneration was not present among infertile patients with endometriosis.Results:Although MCTs do not seem to negatively affect the ovarian reserve, infertility is prominent in patients with concurrent endometriosis. During assessment, concurrent endometriosis should be considered. Imaging findings, large adnexal masses, and postmenopausal period are important for the assessment of MCT concerning malignant degeneration. It should not be overlooked because tumor markers may be normal.Conclusion:MCTs can be present concurrent with endometriomas. In such cases, infertility is more distinct. In MCT malignant degeneration, mass diameter, complex mass internal structure, and postmenopausal status are important factors.

First case of mature teratoma and yolk sac testis tumor associated to inherited MEN-1 syndrome: a case report

First case of mature teratoma and yolk sac testis tumor associated to inherited MEN-1 syndrome: a case report

Histopathological Study of Teratoma Diagnosis in Ovaries of Cattle at South of Iraq

Three cases of ovarian teratoma in bovine were diagnosed at first time in southern of Iraq. Through investigation of ovaries in 120 cows. Showed macroscopical description of ovaries lesions which were bilateral malignant tumors on external surface for each ovary (left and right).The specific characteristics of this tumor was presence of hair embedded within texture of lesion which represented to embryo remnants, As well as, the study revealed a histological exploration of tumor that. Granulosa cells under go different stages of mitotic divisions were noted during the histological study. Also tumor tissues represented as keratinized squamous epithelial tissue, contained skin adenxal structures such as hair follicle. The closed similarity between teratoma and epidermoid cysts results in misdiagnosis between them. The present study revealed that teratoma is more frequently incidence to the cattle than other demotic animal in addition this tumor had similar features to the teratoma in women.

Organ-sparing partial orchietectomy for testicular adenomatoid tumor

The incidence of testicular tumors is relatively low which are mainly malignant, so the main way to treat testicular tumors is radical testicular resection. Testicular adenomatoid tumor is a rare testicular benign tumor, but is easily misdiagnosed as malignant tumors with removal of organs. This article aims to explore the clinical features of testicular adenomatoid tumor and its treatment. There were 133 cases of testicular tumor in the Peking University Third Hospital from May 1994 to November 2016. We conducted a retrospective analysis of three patients who underwent the treatment of partial orchiectomy with preservation of the organ and were pathologically diagnosed with testicular adenomatoid tumor after surgery. The follow-up was done by outpatient clinics and telephone inquiry after surgery. The related literature was also reviewed for further discussion. Of all the 133 patients, 116 had radical resection of the testis and 17 had partial testicular resection due to specific reasons (5 cases of epidermoid cyst, 4 cases of teratoma, 3 cases of seminoma, 3 cases of adenomatoid tumor, and 2 cases of Sertoli cell tumor). The mean age of the 3 patients was (42.67±10.97) years (30-49 years), the mean hospital stay was (9.00±5.20) d (6-15 d), the mean body mass index was (26.20±1.42) kg/m2 (25.00-27.76 kg/m2), the mean serum human choionic gonadotophin (HCG) was (1.15±0.11) IU/L (1.07-1.23 IU/L) (all normal) and the mean serum alpha-fetoprotein (AFP) was (2.12±0.66) μg/L (1.65-2.58 μg/L) (both were normal). Ultrasound features revealed a clear or unclear border, solid, moderate echo nodule tumor in the testis. The mean maximal diameter of the tumor was (1.00±0.44) cm (0.50-1.30 cm), and the mean duration of intraoperative warm ischemia time was (19.67±17.10) min (0-31 min) (only the last two cases). No recurrence or malignant transformation was observed during the follow-up. Testicular adenomatoid tumor is mainly based on the characteristics of ultrasound to determine preoperatively, but easy to be misdiagnosed with testicular radical resection. The recommended surgery for adenomatoid tumor is partial resection of the testis via the inguinal approach according to the frozen section pathology to determine whether to retain the organ.

Acoustic Streaming: A Diagnostic Clue to Diagnosing Testicular Teratoma

Teratomatous tissue is commonly seen in a variety of malignant testicular tumors, and while the exact determination of testicular tumor subtypes heavily relies on pathologic diagnosis, ultrasound remains the gold standard in the initial evaluation of such entities. The major groups of testicular tumors may demonstrate characteristic features which can point the radiologist toward a more pruned differential diagnosis. While it is important for the interpreting physician to be aware of such features, it is of equal necessity that they are aware of potential visual phenomena, such as acoustic streaming in the diagnosis of testicular tumors. We present a case of a testicular teratoma with acoustic streaming. This testicular tumor was confirmed to be predominantly a teratoma with a minimal element of seminoma on histopathology.

MON-424 Suprasellar Immature Cystic Teratoma: A Case Report

Background: Intracranial teratomas are rare and comprise about 0.5% of all intracranial tumors. Actually, a total of 15 cases of sellar-suprasellar teratoma have been described in the last 26 years. Teratomas occur more frequently in children and young adults than in the older population and in males as compared to females. Symptoms at diagnosis are usually neurological defects, diabetes insipidus, and hypopituitarism. Teratoma diagnosis can be suggested through neuroimaging findings. Magnetic Resonance Imaging (MRI) remains the preferred modality. Neuro-radiological findings of mixed-density mass, usually with mixed cystic and solid components inclusions of teeth, fat, and calcification can be suggestive. Tumor markers as beta-HCG and alpha-FP can be useful. Optimal treatment for mature teratoma is neurosurgical excision and in cases of immature teratomas or mixed germ cells tumors teratomas, a multi-step treatment is required with neurosurgical excision, adjuvant or neo-adjuvant radiotherapy and chemotherapy. Clinical Case: A 15-year-old woman, with a headache, secondary amenorrhea, syncope, progressive visual loss, polydipsia, and polyuria due to diabetes insipidus. A craniopharyngioma or another parasellar mass was suspected, an MRI showed an expansive suprasellar process with a cystic component with chiasm compression. A hormone panel showed corticotrophic and thyrotrophic deficiencies. Hormone replacement was started and the patient was referred for surgery. The immediate postoperative progressed well, although one month later she presented recurrence of the compressive symptoms (a headache and visual loss). She was submitted to second surgery. According to the pathology, the mass was identified as a suprasellar immature teratoma, with germ component, as well as cystic areas (ki67: 80%). In addition, tumor markers tests were requested: beta-HCG 5.47mIU/mL (<5.0), alpha-FP 3.1ng/mL (<7.0), DHL 635U/L (240-480). The patient was staged and referred to oncology unit that indicated radiotherapy, as a postoperative adjuvant therapy. At the most recent follow-up, approximately 9 months later, MRI shows a residual, stable tumor and patient presents with bitemporal hemianopsia. Conclusion: Intracranial germ cell tumors are uncommon, with only 15 cases of sellar-suprasellar teratoma described in the literature. It is important to recognize this entity in the differential diagnosis once they mimic many other lesions. Future reports on this rare location for a teratoma may help ascertain long-term outcomes. Reference: Chiloiro, S., Giampietro, A., Bianchi, A., & De Marinis, L. (2015). Clinical management of teratoma, a rare hypothalamic-pituitary neoplasia. Endocrine, 53(3), 636-642. doi:10.1007/s12020-015-0814-4

SUN-603 A Case of Papillary Thyroid Cancer and EXTRAOVARIAN Pelvic Teratoma

INTRODUCTION Teratomas comprise a spectrum of tumors that have striking imaging appearances and are commonly considered when evaluating a mass in the female pelvis. A subgroup of these tumors located in an extragonadal abdominopelvic location, in contrast, are extremely rare. Thyroid tissue in teratoma may demonstrate the same spectrum of pathological features as in the normal thyroid including benign and malignant changes. Herein, we describe a case of papillary thyroid cancer of the thyroid gland with incidentally diagnosed extraovarian pelvic teratoma. CASE 52 y.o. woman with locally-invasive, multifocal, papillary thyroid carcinoma (PTC) s/p radical thyroidectomy and left central neck dissection. She was treated with thyrogen stimulated 100 mCi I-131, and her post-therapy whole body scan showed uptake in thyroid bed and in the right lower quadrant, for which SPECT imaging was acquired to assess this region better. SPECT imaging showed a heterogeneous, solid lesion seemed to be arising from the left adnexa, which correlated with the region of tracer uptake. The lesion contained fat and dystrophic calcifications with differential considerations including ovarian teratoma/struma ovarii. Her thyrogen stimulated thyroglobulin level was 66 ng/ml. She underwent laparoscopic exploration of the pelvis. Interestingly, the pelvic mass was noted to be completely separate from the left ovary. Pathology result showed a dermoid cyst with thyroid tissue. DISCUSSION A dermoid cyst is a cystic teratoma, usually benign, that contains an array of developmentally mature, solid tissues. In most cases, thyroid tissues found in teratomas are ovarian, not extra-ovarian. There are some case reports of thyroid carcinoma arising in a struma ovarii (thyroid tissue in ovarian teratoma) and a few case reports of synchronous carcinoma in the thyroid gland and the struma ovary. For cases with incidentally found teratoma with thyroid tissue, the next step is to proceed with further work up to confirm the diagnosis and to explore the possibility of a malignant lesion in the mass- either primary or metastasis. For our case, suspicion for metastasis was low as thyrogen stimulated thyroglobulin level was not very high to suggest a distant metastasis. Another important clinical question is whether the iodine uptake in the thyroid tissue in the teratoma will interfere the radio-iodine uptake of the micrometastasis and the long-term outcome. CONCLUSION Radioiodine uptake in the pelvic mass raises the question of possible thyroid tissue- teratoma vs. metastasis. Although teratoma with thyroid tissue might be an incidental finding, this might change the long-term outcome of patients with thyroid cancer treated with radioiodine.

How to differentiate congenital pancreatic cysts and cystic pancreatic teratomas?

The differential diagnosis of congenital pancreatic cysts and mature cystic pancreatic teratomas is challenging due to the lack of reliable diagnostic tests or pathognomonic imaging findings. This study highlights the differences between these extremely rare entities with few published case reports. Based on our recent experience with two cases, we conducted an extensive review of literature including all reported cases of congenital pancreatic cysts and cystic pancreatic teratomas in children. We report two cases of large cystic abdominal mass detected by prenatal ultrasonography. Both neonates were asymptomatic after birth and were operated on by laparoscopy at the age of 1 year and 3 months, respectively. Histopathology demonstrated a congenital pancreatic cyst in the first case and a mature cystic teratoma in the second case. The post-operative course was uneventful for both children. We describe the clinical and imaging data of the 33 congenital pancreatic cysts and 10 mature cystic teratomas of the pancreas previously reported in the literature, and discuss diagnosis criteria and treatment strategies. Congenital pancreatic cysts and pancreatic teratomas are rare lesions in children. Clinical presentation is not specific and these lesions are often asymptomatic. Although associated malformations are evocative of congenital pancreatic cyst, the final diagnosis can only be confirmed by histopathological examination. Available treatments include ultrasound-guided puncture, enucleation, distal pancreatectomy, cystogastrostomy, and cysto-jejunostomy by the Roux-en-Y technique. Laparoscopic excision can be performed shortly after birth and is our preferred option.

Struma Ovarii, A Rare Ovarian Tumor: Case Report

Struma ovarii represents a rare type of teratoma that is formed entirely of thyroid tissue. In most cases, these tumors are benign; however, malignant ones have also been reported. It is usually seen between 40 and 60 years and accounts for about 5 % of all cases of ovarian teratomas. Our case was a female patient, 40 years old, who was presented with vaginal bleeding, abdominal swelling and left sided pelvic mass for six months. Clinical examination and imaging techniques showed left ovarian neoplastic lesion and small amount of fluid in Douglas pouch. After laparoscopic excision, Histopathological examination was performed, it showed ovarian tissue, predominantly formed of mature thyroid tissue which are the key features of struma ovarii. In Conclusion: Struma ovarii is a rare ovarian tumor with variable clinical presentations, even can be malignant. Pre-operative diagnosis is usually difficult and confusing, so, it should be put in consideration in differential diagnosis of ovarian masses.

Infratentorial immature teratoma of congenital origin can be associated with a 20-year survival outcome: a case report and review of literature

BackgroundCongenital intracranial tumors are very rare and account for less than 2% of all childhood brain tumors. Teratomas constitute about one third to one half of these, predominantly located midline in the supratentorial region. Posterior fossa location rarely occurs and, based on the cases reported in the literature, commonly has a poor prognosis.Case presentationA newborn female, diagnosed prenatally with hydrocephalus, is presented at birth with increasing head circumference and Parinaud’s syndrome. Magnetic resonance imaging scans demonstrated a huge posterior fossa tumor with obstructive hydrocephalus. At surgery, through a suboccipital craniotomy, complete excision was achieved of a histological-proven immature teratoma. The infant received adjuvant chemotherapy for 1 year. She had normal neurological development and remained tumor-free through her 20-year follow-up.ConclusionThe authors report this rare case of congenital posterior fossa teratoma with long-term outcome, and the literature is reviewed.

Identification of a giant mediastinal teratoma by echocardiography: A case report

The diagnosis of mediastinal space-occupying lesions largely relies on X-ray and computed tomography. However, thanks to technological progress, transthoracic echocardiography can clearly display the mediastinal structures surrounding the heart and great vessels, thereby improving the detection rate of mediastinal space-occupying lesions. Primary mediastinal teratoma is relatively rare, and removal of giant mediastinal teratoma by thoracoscopic surgery has rarely been reported. Here, we report a case of giant mediastinal teratoma diagnosed by transthoracic echocardiography, which was treated by complete thoracoscopic resection and confirmed by histology.