Orbital immature teratoma: A rare entity with diagnostic challenges

A rare case of fetal retroperitoneal solid mature teratoma

article's main point: This article retrospectively analyzes clinical data from a rare case of fetal retroperitoneal solid, mature teratoma, aiming to provide insights into diagnosing and treating fetal teratomas. This case of fetal retroperitoneal teratoma provides the following insights into diagnosis and treatment: 1) Due to the special nature of the retroperitoneal space, retroperitoneal tumours grow hidden, especially in fetal retroperitoneal tumours that are even more difficult to detect. Prenatal ultrasound screening is of great value for the diagnosis of this disease. 2) Although ultrasound can determine the location and blood flow of the tumour and monitor changes in its size and composition, there is a certain degree of misdiagnosis due to fetal position, clinical experience, and imaging resolution. When necessary, fetal MRI can provide further evidence for prenatal diagnosis. 3) Although fetal retroperitoneal teratoma is rare, a few tumours grow rapidly and have the potential for malignant transformation. When a solid cystic mass lesion in the retroperitoneal space is found during the fetal period, this disease should be considered as one of the differential diagnoses and distinguished from fetal renal tumours, adrenal tumours, pancreatic cysts, meconium peritonitis, parasitic fetus, and lymphangioma, among others. 4) Based on the situation of the pregnant woman, fetus, and tumour, the time and method of termination of pregnancy should be decided. After birth, the timing and manner of surgery and postoperative follow-up should be determined by neonatology and pediatric surgery.

Congenital mature orbital teratoma: A case report

Teratomas are gonadal or extragonadal neoplasms, derived from the three embryonic tissues, composed of germ cells of the neuroectoderm, mesoderm and ectoderm. Congenital orbital teratoma (OCT) commonly affects the left orbit, primarily affecting women over men at a ratio of 2:1. We present the case of a female patient of 9 days of extrauterine life with a left mature congenital orbital teratoma. The orbit and oculoplastic service performed an orbital exenteration and total resection of the tumor mass.

Congenital orbital teratoma: a case report with preservation of the globe and 18 years of follow-up

Background

Congenital orbital teratomas are extremely rare, usually benign neoplasms, comprised of cells originating from all three germ cell layers. Clinically the tumor appears solid, most of the times is intraconal and presents as a rapidly growing mass leading to a massive unilateral axial proptosis, chemosis, exposure keratopathy, markedly distended eyelids and often, loss of vision. To prevent these complications, tumor excision usually involves enucleation or even orbital exenteration.

Case presentation

We report a case of a 1-day old infant who presented with dramatic proptosis at birth due to a true congenital orbital teratoma. We describe the clinical findings, the preoperative neuroimaging, the surgical management which included complete tumor resection with preservation of the globe to allow for optimal orbital growth, the histopathological evaluation, and the clinical course during 18 years of follow up.

Conclusion

Every effort to salvage the globe should be made to achieve the best possible orbito-facial development. Furthermore, the value of prompt surgical management with a less invasive transconjunctival globe sparing procedure can be appreciated in our case.

Congenital orbital teratoma: A clinicopathologic case report

Here we report an extremely rare case of immature congenital orbital teratoma. The ultrasound scan at the 28⁺¹ week of gestation revealed a massive, solid, and cystic mass in the left orbital region of the fetus. The lesion site was confirmed by magnetic resonance imaging. Based on clinical examination and imaging, the diagnosis of orbital teratoma without intracranial extension was made. Histopathological examination further confirmed the diagnosis of immature teratoma. The clinical course, radiographic, and histopathological findings of this disease were also summarized.

Prenatal Exophthalmia Revealing a Postnatal Orbital Teratoma

Purpose

Teratomas are congenital tumors of stem cells derived from the three germ layers. They are frequently located in the sacrococcygeal region. Orbital teratoma is rare with less than 70 cases reported until 2016. We report the case of prenatal exophthalmia discovered by ultrasound exam which turned out to be a teratoma postnatally. The newborn in our case was female, just as described in the literature. Treatment consisted of total removal of the teratoma and the eyeball. Reconstructive surgery remains a big challenge since our medical technology is limited.

Conclusion

A prenatal exophthalmia on fetal ultrasound should make us think of a teratoma, even if it is very rare. Fetal orbital teratoma may be associated with fetal survival. The infant will benefit from a reconstructive surgery of the orbit.