Mature solid teratoma of the rectum: report of a case

Primary Mature Teratoma of the Rectum: A Case Report

Patient: Female, 68-year-old

Final Diagnosis: Primary mature teratoma of the rectum

Symptoms: Hematochezia

Medication:—

Clinical Procedure: Colonoscopy with polypectomy

Specialty: Gastroenterology and Hepatology

[Thoracoabdominal teratoma--rare location]

INTRODUCTION

Teratomas are tumours derived from pluripotent germ cells. They appear most frequently on ovaries. However, other locations are also possible: testicles, retroperitoneum, stomach, neck, and bottom of the mouth cavity. It is not very common to find teratomas in two different body cavities.

CASE REPORT

A 51-year-old patient visited her doctor complaining of an intensive pain which suddenly appeared in her low back. The computed tomography scan of the abdomen was performed, which revealed cystic formation, 12.5 x 18 cm in size, with remarkable capsule visualization. It had paraaortic, subdiaphragmatic, retropancreatic and suprarenal left localisation with signs of compression and pancreatic dislocation. The cystic formation had a septated appearance filled with clear fluid in all its parts except at the bottom, where it was dense. The intra-operative finding was left retroperitoneal mass placed above the left kidney, dislocating surrounding structures and their infiltration could not be excluded for sure. A tumour mass passed through the diaphragmatic hiatus and continued in the left thoracic space. The cyst was only drained and the fenestration was performed. Three months later, the second operation was performed--splenectomy, left suprarenaladenectomy, left nephrectomy, aortic deliberalisation, the left diaphragmatic crus was opened and tumour mass was completely removed from the thoracic space. The histological examination showed mature teratoma with morphological characterisations of the skin, so the definite diagnosis was dermoid cyst.

CONCLUSION

The patient presented with thoracoabdominal teratoma. Although without malignant transformation, the teratoma required splenectomy, supraadrenalectomy and nefrectomy due to its position and size.

Castleman's disease of the mesorectum: report of a case

Castleman's disease is a benign lymphoid proliferative disorder, which most commonly presents as a solitary mass in the mediastinum, although extrathoracic sites have been reported in the neck, axilla, pelvis, mesentery, pancreas, and retroperitoneum. We report a case of asymptomatic, isolated Castleman's disease in the mesorectum, which is extremely rare. The patient was a 34-year-old woman who underwent investigations for vaginal spotting. A presacral mass was located on the left side of the rectum, 10 cm from the anal verge. Contrast-enhanced computed tomography showed a large, well-demarcated, strongly enhancing mass with internal radiating septa in the mesorectum. The mass was well circumscribed and isointense to muscle on T1-weighted magnetic resonance imaging, appearing as a slightly hyperintense mass on T2-weighted imaging. We performed laparoscopic mesorectal mass excision, and histological examination revealed features typical of the hyaline-vascular type of Castleman's disease. Thus, when a mesorectal mass is being investigated, Castleman's disease should be considered in the differential diagnosis.