Cervical cystic swelling in an adolescent: unusual association of a cervical mature teratoma with vertebral anomalies and a history of gastric duplication cyst

A case report of a giant mature teratoma of the thyroid gland in a young girl

RATIONALE

Teratomas are extremely rare in the thyroid gland. A cervical teratoma presenting as a cystic or mixed thyroid lesion can be easily confused with a thyroglossal duct cyst. It is difficult for pediatricians to differentiate between these 2 types of lesions.

PATIENTS CONCERNS

A 2-year-old girl who presented a growing thyroid mass for 14 months showed a mass in her left thyroid lobe under contrast-enhanced computed tomography (CT).

DIAGNOSIS AND INTERVENTIONS

Ultrasonography found a mass of 5 × 3.5 cm within the left lobe of the thyroid gland, and the sonogram revealed areas with echo-free and mixed-echo patterns. There was no accumulation of technetium-99m pertechnetate on the thyroid scintigraphy (cold thyroid nodule). CT scan showed a mass (5.0 × 3.0 × 2.5 cm in size) that extended from the left thyroid lobe to the anterior mediastinum with no evident enhancement and clear margins that contained calcifications. Complete excision without intraoperative capsule disruption was achieved. Histologically, the thyroid mass was diagnosed as a mature teratoma.

OUTCOMES

The postoperative course was uneventful after follow-ups for 2 years, and the patient had no inflammatory signs or evidence of recurrence.

LESSONS

Thyroid teratoma is rare in infants and is usually benign; however, some thyroid teratomas are malignant and inclined to relapse. The authors emphasize that thyroid teratomas in children should be included in the differential diagnosis of cystic lesions located in the head and neck area. Complete resection is essential for good outcomes. In addition, long-term follow-ups are warranted to follow the complications of the malignant or recurrent disease.

Asymptomatic perforated gastric duplication clogged by omentum, anorectal malformation and agenesis of the corpus callosum: A rare combination

Gastric duplication cysts are uncommon congenital anomaly and its association with other malformations is rarely reported. Many theories exist for the development of these lesions. This case report describes coincidental detection of perforated gastric duplication clogged by the omentum associated with anorectal malformation and agenesis of the corpus callosum.

Cystic cervical teratoma: A diagnostic and management challenge

Cervical teratomas are relatively rare congenital tumors pathologically defined by their three germ cell layer composition. Classically they manifest as solid or mixed solid-cystic lesions. Purely cystic teratomas pose a diagnostic challenge due to their clinical and radiologic similarity to lymphatic vascular malformations. Sclerotherapy, rather than operative excision, may be offered as therapy. We present an unusual cystic neck mass to highlight this dilemma.