Teratoma gástrico. Caso clínico

Introducción: Reportamos los hallazgos clínicos, quirúrgicos, imagenológicos e histopatológicos de un paciente con Teratoma Gástrico. Materiales y Método: Se recopilaron variables clínico demográficas, imagenológicas, quirúrgicas y post operatorias, analizándolas de forma descriptiva. Resultados: Paciente masculino de 33 años que presenta cuadro de TVP (trombosis venosa profunda) que se decide complementar con Angiotc donde se constata aumento de volumen nodular en relación a la curvatura menor del estómago. Se complementa estudio con endoscopía digestiva alta que muestra lesión infiltrante, extensa en curvatura menor. Se decide realizar gastrectomía total laparoscópica. Estudio histopatológico muestra en curvatura menor, histopatología compatible con teratoma maduro. Paciente con evolución satisfactoria post operatoria se decide alta médica, control a los 7 meses post operado sin complicaciones. Discusión: El teratoma gástrico es un tumor infrecuente, se caracteriza por su composición heterogénea. Se diagnostica comúnmente en niños pequeños, aunque puede ocurrir a cualquier edad. La causa exacta del teratoma gástrico es desconocida, pero se cree que se desarrolla debido a anomalías durante el desarrollo embrionario. Su diagnóstico de teratoma implica una combinación de estudios. Histológicamente, los teratomas gástricos están compuestos de tejidos de diferentes capas de células germinales, incluyendo ectodermo, mesodermo y endodermo. Conclusión: los teratomas gástricos son tumores extremadamente inusuales, que pueden ser difíciles de diagnosticar y manejar, se requiere un enfoque multidisciplinario para un manejo óptimo.

Introduction: to present the clinical, surgical, imaging, and histopathological findings of a patient with a gastric teratoma. Materials and Methods: Descriptive analysis was conducted on clinical, demographic, imaging, surgical, and postoperative variables collected. Results: A 33-year-old male patient was diagnosed with deep vein thrombosis (DVT), and an angiotc scan revealed an increase in nodular volume in the lesser curvature of the stomach. Upper digestive endoscopy showed an infiltrating lesion extensively affecting the lesser curvature. Laparoscopic total gastrectomy was performed, and histopathological examination confirmed the presence of a mature teratoma in the lesser curvature. The patient experienced a satisfactory postoperative recovery and was discharged. Follow-up at 7 months postoperatively showed no complications. Discussion: Gastric teratoma is a rare tumor characterized by its heterogeneous composition. While it is typically diagnosed in young children, it can occur at any age. The exact cause of gastric teratoma is unknown, but it is believed to result from embryonic developmental anomalies. Diagnosis of teratoma involves a combination of diagnostic tests. Histologically, gastric teratomas consist of tissues derived from different layers of germ cells, including ectoderm, mesoderm, and endoderm. Conclusion: Gastric teratomas are extremely uncommon tumors that pose challenges in terms of diagnosis and management. An interdisciplinary approach is necessary for optimal management.

Teratoma mesentérico maduro en una mujer adulta: reporte de caso y revisión de la literatura / Mature mesenteric teratoma in an adult women: Case report and literature

Introducción. Los teratomas son neoplasias que surgen a partir de células germinales pluripotenciales y derivan de dos o más capas de células. Se clasifican en tumores maduros, que contienen tejidos bien diferenciados, o inmaduros, que contienen estructuras inmaduras y embrionarias. Su localización más frecuente son las gónadas; la ubicación mesentérica es infrecuente y se han descrito aproximadamente 40 casos en la literatura mundial. Dentro del abordaje diagnóstico y terapéutico, se emplea la tomografía computarizada y la resonancia magnética nuclear para caracterizar la lesión, evaluar la extensión intraabdominal y la relación con otras estructuras. El diagnóstico debe confirmarse mediante el examen histopatológico. Caso clínico. Paciente femenina de 56 años, con antecedente de carcinoma ductal infiltrante de mama izquierda en remisión, en estudios de seguimiento con hallazgo incidental en tomografía de abdomen de lesión abdominopélvica dependiente del mesenterio, contornos lisos y nivel grasa-líquido. Estudios de extensión con marcadores tumorales negativos. Resultados. Por la alta sospecha clínica e imagenológica de teratoma, fue llevada a resección quirúrgica de la lesión. El examen histopatológico confirmó el diagnóstico de teratoma quístico maduro del mesenterio. Conclusión. El teratoma mesentérico es una entidad clínica rara, que debe ser considerado como uno de los diagnósticos diferenciales de una masa abdominal con efecto compresivo. El diagnóstico se basa principalmente en el examen clínico y los hallazgos imagenológicos. La escisión quirúrgica temprana es el pilar del tratamiento; el abordaje laparoscópico o abierto depende de las características clínicas y la experiencia del cirujano.

Background. Teratomas are neoplasms that arise from pluripotent germ cells, derived from two or more layers of germ cells. They are classified as mature tumors (cystic or solid), which contain well-differentiated tissues, or as immature tumors, which contain immature and embryonic structures. Its most frequent location is the female and male gonads; the mesenteric location is rare and approximately 40 cases have been described in the world literature. Within the diagnostic and therapeutic approach, computed tomography and magnetic resonance imaging are used to characterize the lesion, assess intra-abdominal extension and the relationship with other structures. The diagnosis must be confirmed by histopathological examination. Clinical case. A 56-year-old female patient with a history of infiltrating ductal carcinoma of the left breast in remission. In follow-up studies, incidental abdominal tomography finding of an abdominopelvic lesion dependent on the mesentery at the level of the mesogastrium, smooth contours with fat-liquid level. Extension studies with negative tumor markers. Results. Due to high clinical and imaging suspicion of teratoma, the patient was taken to resection of the lesion. Histopathological examination confirmed the diagnosis of mature cystic teratoma of the mesentery. Conclusion. Mesenteric teratoma is a rare clinical entity and is considered one of the differential diagnoses of an abdominal mass with a compressive effect. Diagnosis is mainly based on clinical examination and imaging findings. Early surgical excision is the mainstay of treatment; laparoscopic or open approach depends on the clinical characteristics and the experience of the surgeon.

Imaging analysis of malignant transformation of ovarian mature teratoma / 实用放射学杂志

Objective To analyze the imaging manifestations of malignant transformation of ovarian mature teratoma.Methods The clinical data and CT and MRI imaging findings of four patients confirmed as malignant transformation of ovarian mature teratoma by operation and pathology were analyzed retrospectively.The following imaging features were assessed:size,shape,texture,enhancement degree and pattern,et al.Results Among the four cases,three lesions were located in the left ovary and one in the right ovary.The minimum size and maximum size were 87 mm×80 mm×87 mm and 171 mm×141 mm×215 mm,respectively.All of the lesions showed as round-like or ovoid cystic masses with fat-fluid level(4/4),and floating mixed density or signal masses(2/4).The demonstrated local thickening of the cyst wall(2/4)and/or soft mass growing across the wall(3/4),with significant inhomogeneous enhancement(2/3).Conclusion The malignant transformation of ovarian mature teratoma often presents as a cystic mass with fat-fluid level,and local thickening or soft mass of the cyst wall,with significant enhancement.It should be considered in the elderly patients with abnormal tumor markers and above imaging features.

Coincidental finding of Sertoli-Leydig Cell Tumor in a postmenopausal woman with mild hyperandrogenism, ovarian teratoma, and pelvic organ prolapse: A case report

@#A Sertoli-Leydig cell tumor (SLCT) is an extremely rare type of sex cord stromal tumor of the ovary, which mainly secretes testosterone, thus manifestations of hyperandrogenism commonly appear. This paper shall discuss a case of a postmenopausal woman who presented with pelvic organ prolapse, large left ovarian cyst and mild signs of hyperandrogenism. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, which on microscopic examination of the specimens, revealed a Mature cystic teratoma on the left ovary and an incidental finding of a well-differentiated SLCT, on the grossly normal-looking ovary. This histopathologic diagnosis of SLCT explained the patient’s hyperandrogenic characteristics. Authors likewise discussed the proper management of SLCT, including immunostaining and need for adjuvant chemotherapy.

Prolonged survival after thoracic metastasectomy in patients with nonseminomatous testicular cancer

Abstract Introduction Almost 20 % of patients with Non-Seminomatous Germinative Cell Tumors (NSGCT) will require intrathoracic metastasectomy after chemotherapy. The authors aim to determine their long-term survival rates. Methods Retrospective study including patients with NSGCT and intrathoracic metastasis after systemic therapy from January 2011 to June 2022. Treatment outcomes and overall survival were analyzed with the Kaplan-Meier method. Results Thirty-seven male patients were included with a median age of 31.8 years. Six presented with synchronous mediastinum and lung metastasis, nine had only lung, and 22 had mediastinal metastasis. Over half had retroperitoneal lymph node metastasis. Twenty-two had dissimilar pathologies, with a discordance rate of 62 %. Teratoma and embryonal carcinoma were the prevalent primary tumor types, 40.5 % each, while teratoma was predominant (70.3 %) in the metastasis group. Thoracotomy was the main surgical approach (39.2 %) followed by VATS (37.2 %), cervico-sternotomy (9.8 %), sternotomy (5.8 %), and clamshell (3.9 %). Lung resection was performed in 40.5 % of cases. Overall, 10-year survival rates were 94.3 % with no surgical-related mortality. Conclusion Multimodality treatment with systemic therapy followed by radical surgery offers a high cure rate to patients with intrathoracic metastatic testicular germ cell tumors.

Encefalitis autoinmune y síndrome paraneoplásico por teratoma maduro ovárico / Autoimmune encephalitis and paraneoplasic syndrome due to ovarian mature teratoma

Antecedentes: La encefalitis por anticuerpos contra el receptor de N-metil-D- aspartato (NMDAr), fue descrita por primera vez en 2005, y en 2007 Dalmau et al identificaron los anticuerpos contra el receptor NMDA. Se estima que anualmente hay 1.5 casos por cada millón de habitantes con mayor frecuencia en mujeres jóvenes entre 15 a 25 años, puede presentarse como un síndrome paraneoplásico asociado a teratoma ovárico en un 37%. Descripción del caso clínico: Femenina de 17 años con antecedente de teratoma de ovario izquierdo de recién diagnóstico, una semana posterior a la resección quirúrgica presenta: alucinaciones auditivas, ideación de persecución, insomnio, anhedonia, agitación psicomotriz, alteraciones del habla, discinesias orofaciales y alteraciones en la marcha, de un mes de evolución. El electroencefalograma (EEG) reportó hallazgos de disfunción cortico-subcortical severa según reporte por clínica privada sin acceso al estudio. La Resonancia Magnética (IRM) cerebral y citoquímica de líquido cefalorraquídeo (LCR) sin anormalidades. Ante sospecha clínica se inició tratamiento inmunosupresor con corticosteroides intravenosos y manejo sintomático antipsicótico, para agitación y ansiedad; inicialmente con midazolam en infusión y luego con olanzapina, risperidona y clonazepam; obteniendo una evolución clínica satisfactoria. Finalmente, se confirmó el diagnóstico al obtener un resultado positivo para IgG contra la subunidad N1 de glutamato (GluN1) del NMDAr. Conclusión: La encefalitis anti NMDAr es una condición rara y subdiagnosticada, puede confundirse con una enfermedad psiquiátrica primaria. Ante un primer episodio psicótico se debe hacer un interrogatorio y evaluación extensa, con la finalidad de descartar causas secundarias, como los trastornos autoinmunes con repercusiones neurológicas...(AU)

Choroid plexus papilloma in a mature cystic teratoma of ovary: A rare case report

Mature cystic teratoma of the ovary is the most common type of germ cell tumor. It constitutes approximately 20% of all ovarian neoplasms. As a rare occurrence, however, several types of benign and malignant tumours developing secondarily in dermoid cysts have been reported. Those of central nervous origin are almost exclusively gliomas of astrocytic, ependymal or oligodendroglial lineage. Choroid plexus tumors are unusual intracranial tumors which comprised of only 0.4?0.6% of all brain tumors. These are neuroectodermal in origin and similar in structure to a normal choroid plexus in the form of multiple papillary fronds mounted on a well vascularized connective tissue stroma. The present case report highlights the presence of a choroid plexus tumor in a mature cystic teratoma of the ovary in a 27?year?old woman who came for safe confinement and cesarean section.

Resección completa en dos tiempos de teratoma quístico gigante del mediastino que debuta con compromiso vital

Objetivo: Describir resolución quirúrgica de teratoma de mediastino en dos tiempos que debuta en paciente con urgencia vital. Materiales y Métodos: Revisión de caso clínico y descripción retrospectiva del manejo quirúrgico realizado. Resultados: Estudio imagenológico evidenció tumor con contenido quístico que comprometía ambos hemitórax. Dado compromiso vital del paciente, se realiza quistocentesis descompresiva en pabellón, seguido de videotoracoscopía que demuestra origen mediastínico y quistectomía parcial por toracotomía. En un segundo tiempo quirúrgico, se reseca remanente vía esternotomía media. Discusión: Los teratomas mediastínicos son extremadamente infrecuentes, reportándose 44 casos en literatura mundial, sin registros a nivel nacional. Afecta a jóvenes sanos, la mayoría asintomáticos, siendo su hallazgo tardío e incidental. El compromiso de estructuras mediastínicas y de vía aérea pueden ocasionar riesgo vital. Conclusión: La descompresión perioperatoria del contenido quístico del teratoma fue fundamental para mantener fuera de riesgo vital al paciente durante el acto quirúrgico.

Objective: To describe the successful surgical resolution of a giant teratoma of the mediastinum that presents with a vital emergency. Clinical Case: Male patient, 30 years old, with no known history, consulted for a 1-year history of dyspnea on minimal exertion, associated with weight loss without dietary restriction. Imaging study showed tumor with cystic content that compromised both hemithorax. Given the patient's vital commitment, decompressive cystocentesis was performed, followed by video-assisted thoracoscopy that showed mediastinal origin and partial cystectomy by thoracotomy. In a second surgical time, resection of the remnant was performed via median sternotomy. Discussion: Mediastinal teratomas are extremely rare, reporting 44 cases in the world literature, with no national registry. They usually affect healthy young people, most of them asymptomatic and therefore, their discovery is late and incidental. In this case, due to the compression of noble structures, perioperative cystic decompression was essential. Conclusion: Perioperative decompression of the cystic content of the teratoma was essential to maintain stable hemodynamics and subsequent surgical resection.

Teratoma quístico maduro de ovario

Introducción: Los teratomas quísticos maduros del ovario, se originan de las células germinales en una falla de la meiosis o de las células premeióticas. Pueden consistir en múltiples células derivadas de una o más de las 3 capas germinales (ectodermo, mesodermo y endodermo). Son los tumores benignos más comunes del ovario. Pueden aparecer a lo largo de la vida, miden menos de 10 cm, son asintomáticos y unilaterales, aunque solo un 10 % de los casos pueden ser bilaterales. Objetivo: Presentar el caso de una paciente virgen con teratoma quístico maduro de ovario bilateral. Caso clínico: Paciente de 20 años de edad, virgen. Atendida en consulta de ginecología por aumento de volumen y molestias abdominales de varios meses de evolución; se detectó una masa ovárica bilateral. Se realizó laparotomía con quistectomía bilateral. El diagnóstico histológico informó teratoma quístico maduro de ovario. Evolucionó satisfactoriamente, sin recidiva. Conclusiones: Los teratomas quísticos maduros del ovario son frecuentes en edad reproductiva y de forma unilateral; cuando lo hacen de forma bilateral tienen baja incidencia, por lo que un diagnóstico y tratamiento oportunos son importantes para evitar complicaciones, recidivas y garantizar la futura fertilidad de la paciente.

Introduction: Mature cystic teratomas of the ovary originate from germinal cells in a failure of meiosis or from premeiotic cells. This may consist of multiple cells derived from one or more of the three germ layers (ectoderm, mesoderm, and endoderm). They are the most common benign tumors of the ovary. They can appear throughout life, measure less than 10 cm, asymptomatic and unilateral, although only 10% of cases can be bilateral. Objective: To present the case of a virgin patient with bilateral mature cystic teratoma of the ovary. Clinical case: 20-year-old patient, virgin. Attended in the Gynecology consultation for volume increase and abdominal discomfort of several months of evolution; Bilateral ovarian mass was detected. Laparotomy with bilateral cystectomy was performed. Histological diagnosis reported mature cystic teratoma of the ovary. He evolved satisfactorily without recurrence. Conclusions: Mature cystic teratomas of the ovary are frequent in reproductive age and unilateral; When they do so bilaterally, they occur at low incidences, so prompt diagnosis and treatment are important to avoid complications, recurrences, and guarantee the future fertility of patients.

Cáncer de células germinales de testículo no seminomatoso con recurrencia tardía: reporte de un caso

Introducción: los tumores de células germinales son comunes en hombres jóvenes, tienden a ser sensibles a la quimioterapia citotóxica y las recurrencias tardías no son tan frecuentes. Caso Clínico: presentamos el caso de un paciente de 53 años con antecedente de carcinoma del testículo derecho no seminomatoso, específicamente un carcinoma embrionario más teratoma inmaduro y tumor de senos endodérmicos, Estadio Clínico IIIC debido a que presentó metástasis retroperitoneales, supraclaviculares y pulmonares a sus 24 años y que presentó una recurrencia tardía supraclavicular izquierda y pulmonares bilaterales 22 años después. Fue tratado con un esquema de quimioterapia alternativo no convencional con respuesta completa permaneciendo así hasta la actualidad. Conclusión: Existe tratamiento de quimioterapia no convencional que son útiles el tratamiento de tumores de células germinales que muchas veces no se exploran en la práctica oncológica. (provisto por Infomedic International)

Introduction: germ cell tumors are common in young men, they tend to be sensitive to cytotoxic chemotherapy and late recurrences are not so frequent. Case report: we present the case of a 53-year-old male patient with a history of non-seminomatous right testicular carcinoma, specifically embryonal carcinoma plus immature teratoma and endodermal sinus tumor, Clinical Stage IIIC because he presented retroperitoneal, supraclavicular and pulmonary metastases at the age of 24 years and presented a late left supraclavicular and bilateral pulmonary recurrence 22 years later. He was treated with an alternative non-conventional chemotherapy scheme with complete response and remains so until the present. Conclusion: There are non-conventional chemotherapy treatments that are useful in the treatment of germ cell tumors that are often not explored in oncologic practice. (provided by Infomedic International)

Teratoma nasofaríngeo inmaduro con diagnóstico prenatal: reporte de un caso y revisión de la literatura / Immature nasopharyngeal teratoma with prenatal diagnosis: Case report and review of the literature

Objetivos: Reportar el caso de una gestante con diagnóstico de feto con teratoma nasofaríngeo inmaduro y realizar una revisión describiendo el pronóstico de esta patología. Materiales y métodos: Se reporta el caso de una gestante de 27 años, atendida en la Unidad de Ginecología y Obstétrica de un centro de referencia en Bogotá (Colombia), por hallazgo durante el control prenatal de un feto con evidencia de polihidramnios secundario a teratoma nasofaríngeo. Se realizó una búsqueda bibliográfica en las bases de datos Medline vía PubMed, Scopus, SciELO y ScienceDirect, restringiendo tipo de idioma (inglés y español) y por fecha de publicación (enero de 2001 a enero de 2021). Se incluyeron reportes de caso y series de casos que abarcaran el pronóstico de esta patología. Resultados: La búsqueda recuperó 168 títulos, de los cuales 55 cumplieron con los criterios de inclusión. En total se reportó el resultado perinatal de 58 fetos con diagnóstico de teratoma nasofaríngeo inmaduro detectado en etapa prenatal. En los casos identificados, la mortalidad perinatal fue del 25,4 % y el porcentaje de óbito fue cercano al 3,6 %. Conclusiones: El teratoma nasofaríngeo inmaduro es una patología poco frecuente. La literatura disponible sugiere que el pronóstico fetal depende del grado de compromiso de las estructuras intracraneales y de la posibilidad de resección de la lesión. Se requieren más estudios que evalúen el pronóstico de los fetos con teratoma nasofaríngeo inmaduro.

Objectives: To report the case of a pregnant woman with prenatal diagnosis of fetal immature nasopharyngeal teratoma, and to conduct a review of the literature describing the prognosis of this condition. Material and methods: We report the case of a 27-year-old pregnant woman who received care at the Obstetrics and Gynecology Unit of a reference hospital in Bogotá (Colombia) because of a finding during a prenatal visit of evidence of polyhydramnios, secondary to a nasopharyngeal teratoma. A literature search was conducted in the Medline via PubMed, Scopus, SciELO and ScienceDirect databases, restricted by language (English and Spanish) and date of publication (January 2001 to January 2021). Case reports and case series covering the prognosis of this condition were included. Results: Overall, 168 titles were retrieved, 55 of which met the inclusion criteria. Perinatal outcomes for a total of 58 fetuses with a diagnosis of immature nasopharyngeal teratoma detected during the prenatal stage were reported. In the identified cases, perinatal mortality was 25.4 % and the percentage of fetal demise was close to 3.6 %. Conclusions: Immature nasopharyngeal teratoma is an infrequent condition. The available literature suggests that fetal prognosis depends on the degree of compromise of intracranial structures and the possibility of resecting the lesion. Further studies are needed to assess the prognosis of fetuses with immature nasopharyngeal teratoma.

Primary ovarian carcinoid: Report of 3 cases / 中国综合临床

Carcinoid is a kind of tumor originating from neuroendocrine cells, which is rare in female reproductive system. Patients with primary ovarian carcinoid are usually difficult to diagnose before operation, and often coexist with ovarian teratoma. Postoperative pathology is the final basis for diagnosis. Adnexectomy is the main choice for treatment. The effect of surgical treatment is satisfied. The clinical data of 3 patients with ovarian carcinoid were analyzed and the literature was reviewed in order to deepen the understanding of primary ovarian carcinoid and guide the clinical therapy.

Struma ovarii quístico: reporte de caso y revisión de la literatura / Cystic struma ovarii: case report and literature review

El struma ovarii es un tumor bastante inusual, hallado en el 2,7 % de los teratomas de ovario. Su variedad quística es bastante rara, siendo su diagnóstico diferencial un cistoadenoma de ovario. Se caracteriza por presentar zona sólida con folículos tiroideos con coloide en su interior, y una zona quística tapizada por un epitelio plano a cuboidal, ambos con marcación para TTF1. Presentamos el caso clínico de una paciente que fue remitida a nuestro hospital por presentar una masa a la palpación vaginal. En imágenes se observa la presencia de una masa anexial derecha quística, por lo cual se le realizó una histerectomía radical con salpingooferectomía bilateral. Luego de estudios de patología y de inmunohistoquímica, se llegó a la conclusión que correspondía a un struma ovarii quístico

Struma ovarii is a rather unusual tumor, found in 2.7% of ovarian teratomas. Its cystic variety is quite rare, with its differential diagnosis being an ovarian cystadenoma. It is characterized by the presence of a solid area with thyroid follicles with colloid inside, and a cystic area lined by a flat to cuboidal epithelium, both with TTF1 marking. We describe the case report of a patient referred to our hospital for presenting a mass on vaginal examination. Imaging studies revealed the presence of a right adnexal cystic mass, for which she underwent a radical hysterectomy with bilateral salpingo-oophorectomy. After pathology and immunohistochemistry studies, it was concluded that it corresponded to a cystic struma ovarii

Teratoma de ligamento redondo, reporte de caso y revisión de la bibliografía / Round ligament teratoma, case report and literature review

Resumen ANTECEDENTES: El teratoma es un tumor casi siempre benigno, con una amplia variabilidad en su localización, extremadamente rara, en el ligamento redondo. CASO CLÍNICO: Paciente de 30 años, con antecedente de un embarazo a término. En la revisión ecográfica se reportó una lesión quística paraovárica izquierda de 46 x 35 mm, sin componente sólido, graso ni calcificaciones. En el examen ginecológico se palpó una masa por encima del útero, orientada hacia el lado izquierdo, no dolorosa. El resto del examen físico trascurrió sin otras alteraciones. La impresión diagnóstica inicial fue de teratoma abdominopélvico sustentada en la ecografía transvaginal en la que los ovarios se observaron normales, con una masa de ecogenicidad mixta de 50 x 40 x 46 mm, con áreas ecolúcidas y ecogénicas de intensidad variable hacia la fosa iliaca izquierda superior, sin contacto con el ovario. El ligamento redondo se seccionó a ambos lados de la masa y se extrajo sin complicaciones; el reporte histopatológico fue de: teratoma quístico maduro. CONCLUSIONES: El ligamento redondo es una localización infrecuente de los quistes dermoides que debe considerarse en los diagnósticos diferenciales de las masas pélvicas; es susceptible de tratamiento quirúrgico por vía laparoscópica.

Abstract BACKGROUND: Teratoma is an almost always benign tumor, with a wide variability in its location; its location in the round ligament is extremely rare. CLINICAL CASE: 30-year-old patient, with a history of a full-term pregnancy. On routine ultrasound examination, a 46 x 35 mm left paraovarian cystic lesion was reported, with no solid, fatty component or calcifications. In the gynecological examination a mass was palpated above the uterus, oriented to the left side, non-painful. The rest of the physical examination passed without other alterations. The initial diagnostic impression was of abdomino-pelvic teratoma supported by transvaginal ultrasound in which the ovaries were normal, with a mass of mixed echogenicity of 50 x 40 x 46 mm, with echolucent and echogenic areas of variable intensity towards the left superior iliac fossa, without contact with the ovary. The round ligament was sectioned on both sides of the mass and removed without complications; the histopathologic report was: mature cystic teratoma. CONCLUSIONS: The round ligament is an infrequent location of dermoid cysts that should be considered in the differential diagnoses of pelvic masses; it is amenable to surgical treatment laparoscopically.

Presentación atípica de teratoma quístico maduro gigante en una paciente adolescente: a propósito de un caso / Atypical presentation of a giant mature cystic teratoma in an adolescent patient: A case report

Introducción: El teratoma quístico maduro es un tipo de tumor derivado de las células germinales que aparece en pacientes en edad fértil. La edad más frecuente de aparición de este tipo de tumores es entre los 20 y40 años.Caso clínico: Se presenta el caso de una paciente adolescente de 18 años con masa abdominal gigante de crecimiento abrupto cuya presentación fue atípica dado el tamaño de esta, el cual se manifestó con dolor abdominal agudo.Tratamiento: Se realiza resección de la masa la cual confirma el diagnóstico histopatológico de teratoma quístico maduro.Conclusión: Este tipo de patologías rara vez se presentan con un crecimiento tan exagerado como el caso de la paciente en mención, y la resolución quirúrgica sigue siendo el gold estándar en cuanto al tratamiento.Palabras clave:DeCS: Teratoma, Células germinativas embrionarias, Adolescente, Neoplasias

Introduction: Mature cystic teratoma is a type of tumor derived from germ cells that appears in patients of childbearing age. The most common age at which this type of tumor appearsis 20 to40.Clinical case: The case of an 18-year-old adolescent patient with a giant abdominal mass of abrupt growth is presented, whose presentation was atypical given its size, which manifested with acute abdominal pain Treatment: Amass resection confirmedthehistopathological diagnosis of mature cystic ter-atoma.Conclusion: This type of pathology rarely presents with growth as exaggerated as in the case of the patient mentioned. Surgicalresolution continues to be the gold standard in terms of treatment

Huge Anterior Mediastinal Teratoma Leading to Orthopnea in a Young Patient

The anterior mediastinal cysts and masses (AMCM) can be of varied origin and presentation. Although the space in the mediastinum is limited the cysts and masses can grow to a large size before the presentation. They displace the adjacent structures and then can grow into the pleural cavities thereby acquiring a large size. We share our experience of a case of a huge anterior mediastinal cystic mass in a young female who had a characteristic presentation of sudden onset breathlessness in the supine position and immediate relief in the sitting position. The patient recovered well after surgical treatment.

Malignant congenital orbital teratoma: Glioblastoma multiforme with primitive neuronal pattern and choroid plexus papilloma: A rare diagnosis at an unusual age

Childhood orbital teratomas are usually congenital lesions that are most often present at birth with progressive, massive unilateral proptosis. During the routine controls of 27-year-old woman between 26–27th weeks of pregnancy her fetal ultrasonography (USG) revealed a mass in the eye of the fetus, and termination was recommended. The family refused the termination option and in the 37th week of pregnancy, vaginal delivery is performed in an external medical center. The mass in the baby's eye was surgically removed. Microscopic examination revealed disorganized ocular tissues, adipose tissue, microcalcification, nerve plexuses as well as areas of neuronal nodules including hypercellular areas, palisatic necrosis, and microvascular proliferation. The immunprofile––patchy GFAP staining in the areas of cellular epithelioid and spindled cells that also show an focal and sparse expression p53 staining and a high proliferation rate in Ki67 staining––confirmed the hematoxylin–eosin (HE) impression of a teratoma with a component of glioblastoma (GBM). In this unique presentation of a malignant orbital teratoma with a GBM, we have identified three tumor components: (1) GBM component, (2) nodules of neuroglial tissue with mature neurons and BRAF mutation, and (3) papillary proliferation possibly representing a choroid plexus papilloma.

Clinicopathological observation of mature teratoma with malignant transformation, a single center retrospective study

Purpose: To investigate the clinicopathological features of mature teratoma with malignant transformation. Methods: Retrospectively analysis of 1179 cases mature teratoma was done from August 1999 to December 2019 in Institution. 14 cases of mature teratoma with malignant transformation were discussed mainly for the pathological characteristics and clinical manifestations. Results: 4 of them were less than 40 years old. All but one occurred in the ovaries, and the one was in the left anterior mediastinum which was the only male. The clinical manifestations of the patients were atypical. Imaging showed cystic solid mass. Surgery was performed. Polypoid mass, solid nodule and thickened area of cyst wall can be seen on the section of tumor. Pathological results show that there were 5 cases of squamous cell carcinoma, 3 cases of carcinoid, 2 cases of serous carcinoma and 2 cases of thyroid papillary carcinoma, 1 case of carcinosarcoma and 1 case of strumal carcinoid. Two cases of squamous cell carcinoma had pelvic and abdominal metastasis. Immunohistochemistry of case 14 showed that AE1/AE3, CD56, SYN, NSE, PSAP, CDX2 were positive in carcinoid. EMA and CK20 were positive in mucinous glands around carcinoid. Calretinin and inhibin were positive in the mesenchyme adjacent to intestinal mucinous gland. Conclusions: Teratoma with malignant transformation is a rare malignancy, although teratoma is a common germ cell tumor. And it's more common in patients over 40 years, especially those patients who were in menopause. Squamous cell carcinoma is the most common type and prone to metastasis. Strumal carcinoid was well-defined, but as an endocrine tumor, it may cause a series of digestive, respiratory or hormonal disorders. Therefore, the mature teratomas should be removed in time after detection.

A Rare Case Of Retroperitoneal Mature Cystic Teratoma In A Young Male Patient

Retroperitoneal mature cystic teratomas are exceedingly uncommon in young male. They are more common in infants and in young females. We report an unusual case of 27 year old male presented with abdominal distension, abdominal fullness and vomiting. Patient underwent ultrasonography and contrast enhanced computed tomography (CT) scan of abdomen which were suggestive of large mature cystic lesion. Patient was planned for surgery and laprotomy was done. A huge retroperitoneal mass was observed and was totally excised. Onhisto-pathological examination (HPE) stratified squamous epithelium with keratin flakes, underlying fibromuscular tissue reveal hair shaft & sebaceous glands and mature cystic teratomawas diagnosed. Retroperitoneal mature cystic teratoma in an older maleis extremely rare. Primary gonadal teratoma with retroperitoneal metastasis should be excluded first. Evaluation of age and location of tumor are critical for its prognosis.