-
International Journal of Surgery Case... Jan 2023Mediastinal mature teratomas are often benign and asymptomatic, but ruptured mediastinal mature teratoma is rare and induces severe complications.
INTRODUCTION AND IMPORTANCE
Mediastinal mature teratomas are often benign and asymptomatic, but ruptured mediastinal mature teratoma is rare and induces severe complications.
CASE PRESENTATION
A male, 23 year old, complained shorthness of breath, right chest pain, fever, and cough. Radiological examination (X-ray, CT-Scan and MRI) showed mediastinal teratoma and pleural effusion. The patient received supportive therapies, including oxygen, symptomatic therapy, antibiotics, and lateral thoracotomy. Empyema culture was positive for Shigella dysenteriae. He was discharged after thirty-six days of hospitalization in good clinical condition.
CLINICAL DISCUSSION
Perforation of mature teratoma is a rare but severe complication. Ruptured mediastinal teratoma can cause extensive pleural adhesions and empyema, making it challenging to perform VATS because of the risk of bleeding and damage to adjacent organs during surgery.
CONCLUSION
Ruptured mediastinal mature teratoma has a good prognosis post-surgical partial resection despite tumor attachment to the pericardium and heart.
PubMed: 36621215
DOI: 10.1016/j.ijscr.2022.107857 -
Surgical Neurology International 2022Teratomas are a unique family of tumors derived from two or more of the three embryonic layers: endoderm, mesoderm, and ectoderm. Mature teratomas are comprised the most...
BACKGROUND
Teratomas are a unique family of tumors derived from two or more of the three embryonic layers: endoderm, mesoderm, and ectoderm. Mature teratomas are comprised the most well-differentiated tissue types and may contain skin, hair, teeth, smooth muscle, respiratory tissues, etc. Infrequently, mature teratomas may be found within the central nervous system and, in exceedingly rare cases, may be occur within the spinal cord itself (i.e., intramedullary/intradural).
CASE DESCRIPTION
A 78-year-old female presented with a subacute progressive lower extremity paraparesis. The MR revealed a cystic 81 × 30 × 25 mm intradural/intramedullary spinal mass involving the distal conus with exophytic extension into the L1-L4 spinal canal. Following surgical intervention consisting of a L1-L4 laminectomy, the lesion was largely removed. Pathology of the mass confirmed a large mature teratoma containing a multilobulated cyst that intraoperatively compressed the conus and cauda equina. Immediately postoperatively, the patient significantly improved neurologically. However, on postoperative day 2, she acutely developed a change in mental status with the left gaze preference and hemiparesis. CT brain in the acute setting showed no evidence of causative pathology and subsequent MR brain was unremarkable. The patient's neurologic deficits progressively improved leading to eventual discharge.
CONCLUSION
Intrathecal intramedullary/extramedullary mature teratomas of the conus that results in subacute cauda equina syndromes are rare. The differential diagnosis for such lesions exophytic to the conus must include mature teratomas which, though rare, may be readily resected resulting in generally favorable outcomes.
PubMed: 35127216
DOI: 10.25259/SNI_845_2021 -
Surgical Case Reports Jan 2022Teratoma is the second most common mediastinal neoplasm, but malignant transformation in mature teratomas is uncommon, and cases of carcinoid tumor with teratoma are...
BACKGROUND
Teratoma is the second most common mediastinal neoplasm, but malignant transformation in mature teratomas is uncommon, and cases of carcinoid tumor with teratoma are described in only a few studies. In addition, multilocular thymic cyst associated with mature mediastinal teratoma is also a rare entity. There have been no reports of case with the coexistence of these three pathological lesions.
CASE PRESENTATION
The patient was a 24-year-old man who was referred to our hospital due to a 2-day history of left shoulder pain, a feeling of severe chest tightness and high fever. Pre-operative computed tomography (CT) showed a large, fluid-filled and well-demarcated multilocular cyst in the anterior to superior mediastinum measuring up to 12 cm in size. Contrast-enhanced CT also revealed that the tumor contained a solid component with slight contrast enhancement and spotty wall-thickening septation. Therefore, cystic thymoma, thymic cyst, cystic teratoma, or germ cell tumor with an inflammatory reaction were considered as differential diagnoses. The patient underwent tumor extirpation under median sternotomy. The pathological diagnosis was multilocular thymic cyst with mature teratoma including carcinoid tumor (Grade 2) in the mediastinum.
CONCLUSIONS
The relationship between thymic cyst, teratoma and carcinoid tumor is unclear at present; therefore, further research is needed to clarify the relationship between these entities. In this report, we present a case of multilocular thymic cyst with mature teratoma including a carcinoid component in the mediastinum that was detected by complete surgical resection.
PubMed: 35092531
DOI: 10.1186/s40792-022-01373-1 -
African Journal of Paediatric Surgery :... 2022Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin...
BACKGROUND
Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin (PT), an enclosed foetus in foetu, or a mature teratoma. The treatment requires complete excision and reconstruction of local anatomy which is not always straightforward.
MATERIALS AND METHODS
PT cases presenting over 12 years were analysed. Patients with complete data, histopathological diagnosis and follow-up were included in the study. During follow-up, specific complications and related investigations were considered.
RESULTS
A total of five patients at four different sites were identified: two retroperitoneal foetus in foetu and three externally attached PTs which were located in the lumbar region, sacrococcygeal area and on the lower anterior abdominal wall. All patients underwent complete surgical excision. In foetus in foetu cases, the blood supply was directly from the aorta with a short stump while the three externally located ones required meticulous and careful dissection with the reconstruction of local anatomy.
CONCLUSION
Parasitic conjoined twinning can present at different sites and surgical challenges vary accordingly. For surface lesions, reconstruction may be as complicated as excision. Prognosis can be affected by the excellence of anatomical restoration. Long-term follow-up is essential to address problems specific to the site of lesion and method of surgical reconstruction.
Topics: Abdomen; Humans; Retroperitoneal Space; Teratoma; Twins, Conjoined
PubMed: 36018202
DOI: 10.4103/ajps.ajps_78_21 -
International Journal of Surgery Case... Apr 2021Mediastinal mature teratomas are often benign, asymptomatic, and incidentally detected during routine chest roentgenography. Enzymes secreted by intestinal or pancreatic...
INTRODUCTION
Mediastinal mature teratomas are often benign, asymptomatic, and incidentally detected during routine chest roentgenography. Enzymes secreted by intestinal or pancreatic tissue in teratomas may lead to mediastinitis or the rupture of adjacent tissues. Herein, we present a case of a patient who experienced sudden onset of chest pain followed by the perforation of a mediastinal teratoma.
PRESENTATION OF CASE
A 10-year-old boy presented with chest pain 2 days before admittance to the hospital. Chest radiography showed an anomalous mass shadow, and computed tomography showed an anterior mediastinal mass. Radiography revealed an increase in the mass shadow size and dullness of the left costal phrenic angle. Magnetic resonance imaging revealed pleural effusion and intratumoral haemorrhage, indicating perforation of the tumour. Emergency excision and thymectomy via sternotomy were performed. Pathology confirmed that the mediastinal tumour presented no immature or malignant elements.
DISCUSSION
In the present case, the onset of chest pain occurred 2 days before admission, and the initial computed tomography did not reveal tumour perforation. Subsequent chest radiography and magnetic resonance imaging indicated that the tumour had perforated. Surgical tumour excision was planned at the time of admission; however, once perforation was confirmed, emergency surgery was performed. The pleural effusion had high cancer antigen 19-9 levels, and this was expected as the pleural effusion contained pancreatic digestive enzymes.
CONCLUSION
The perforation of a mediastinal mature teratoma cannot be predicted based on the symptoms, tumour size, or onset of pain alone. Once perforation is confirmed, surgical excision should be performed immediately.
PubMed: 33887861
DOI: 10.1016/j.ijscr.2021.105807 -
World Journal of Clinical Cases Jul 2022Mature teratoma is a common benign ovarian germ cell tumor, accounting for about 20% of ovarian tumors. The malignant transformation of this tumor is less than 2%. The...
BACKGROUND
Mature teratoma is a common benign ovarian germ cell tumor, accounting for about 20% of ovarian tumors. The malignant transformation of this tumor is less than 2%. The most common type is squamous cell carcinoma, followed by adenocarcinoma. Malignant transformation of colonic mature teratoma is extremely rare. We here report a case of malignant transformation of primary mature teratoma of the colon. The type of malignant transformation was adenocarcinoma.
CASE SUMMARY
A 63-year-old woman was admitted to our hospital due to persistent pain in her right lower abdomen for 1 mo, and she had no nausea, vomiting, blood in the stools, or other symptoms. Preoperative colonoscopy showed uplift of the sigmoid colon mucosa and submucosa. The biopsy showed squamous epithelium. However, contrast-enhanced computed tomography of abdomen and pelvis showed a localized thickening of the sigmoid wall, suggesting colon cancer. Endoscopic ultrasonography (EUS) revealed that the structure of the intestinal wall at the base of the lesion was destroyed, and the boundary between the lesion and the surroundings was unclear. According to the findings of the EUS, the patient did not undergo endoscopic submucosal dissection, but underwent radical resection of the tumor. Histologically, squamous epithelium was seen on the mucosal surface of the colon wall, cartilage and glands were seen under the epithelium, and adenocarcinoma was seen on the muscular layer and serous surface. The final pathological diagnosis was malignant teratoma of the colon. We have followed up the patient for 2 mo since the operation, and the patient recovered well.
CONCLUSION
This case suggests the possibility of mature teratoma in the colon and recognition of malignant types, and it should not be considered as an exclusively ovarian tumor.
PubMed: 36051144
DOI: 10.12998/wjcc.v10.i20.7076 -
The Journal of Veterinary Medical... Apr 2021This report describes the clinical and histopathological characteristics of a rare mixed germ-cell tumor comprising teratoma and embryonal carcinoma in the left ovary of...
This report describes the clinical and histopathological characteristics of a rare mixed germ-cell tumor comprising teratoma and embryonal carcinoma in the left ovary of a 10-month-old four-toed hedgehog, with chief complaints of loss of appetite and lethargy. Laparotomy revealed a swollen left ovary with small disseminated peritoneal nodules, and bilateral ovariohysterectomy was performed. The left ovary had a mature teratoma with well-differentiated fat, bone, cartilage, salivary gland, trachea, keratin cyst, and nervous tissues, and an embryonal carcinoma consisting of poorly-differentiated epithelial cells arranged in tubular, alveolar, or solid patterns. Immunohistochemically, the embryonal carcinoma cells were positive for placental alkaline phosphatase and c-KIT. This is the first case of mature teratoma with embryonal carcinoma in the ovary of a hedgehog.
Topics: Animals; Carcinoma, Embryonal; Female; Hedgehogs; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Placenta; Pregnancy; Teratoma
PubMed: 33536394
DOI: 10.1292/jvms.20-0591 -
Medicina Oral, Patologia Oral Y Cirugia... May 2020Dermoid and epidermoid cysts are slow-growing, benign developmental cysts that arise from ectodermal tissue and can occur anywhere in the body. Less than 7% of these... (Review)
Review
BACKGROUND
Dermoid and epidermoid cysts are slow-growing, benign developmental cysts that arise from ectodermal tissue and can occur anywhere in the body. Less than 7% of these cysts involve the head and neck region, with only 1.6% of cases presenting in the oral cavity. To evaluate the clinical and histopathological features of dermoid (DCs) and epidermoid (ECs) cysts stored in the archives of a referred Oral Pathology Service over a 48-year-period, and to review current concepts about these cysts.
MATERIAL AND METHODS
All DCs and ECs were reviewed, and clinical data were obtained from the patient records. Fourteen cases of DCs and thirteen cases of ECs were re-evaluated microscopically by 2 oral pathologists.
RESULTS
Among 15.387 cases, 14 (0.09%) had a histopathological diagnosis of DCs and 13 (0.08%) of ECs. For DCs, ten (71.4%) patients were women, with the mean age of 37.2 years. All DCs were lined by a stratified squamous epithelium (100%), with gut and respiratory epithelium observed in 1 (7.1%) and 2 (14.3%) cases, respectively. Chronic inflammatory cells, melanin, multinucleated giant cell reaction, and Pacini bodies were also observed. For ECs, eight (61.5%) cases were in women, and the mean age was 38.2 years. All ECs were lined by a stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, and adipose tissue were observed in the fibrous capsule.
CONCLUSION
Our results suggest that stratified squamous epithelium is the predominant epithelial lining of these cystic lesions. Also, we may find some unusual findings in DCs, such as Pacini bodies.
Topics: Adult; Dermoid Cyst; Epidermal Cyst; Epithelium; Female; Humans; Mouth; Retrospective Studies
PubMed: 32134895
DOI: 10.4317/medoral.23388 -
Surgical Case Reports May 2024Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a...
BACKGROUND
Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP).
CASE PRESENTATION
A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications.
CONCLUSION
LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.
PubMed: 38722483
DOI: 10.1186/s40792-024-01918-6