Pediatric pancreatic teratoma: A case report and literature review

Giant teratoma of the pancreas expanding to the mediastinum: Rare tumor and literature review

Pancreatic mature cystic teratomas are very rare with limited cases found in the literature. These lesions raise a diagnostic challenge and complicate the surgical approach not only because of their anatomic position but also because of their ever-growing size. An elusive diagnosis, usually leads to the operative theatre where surgical resection takes place. We present a rare case of a large pancreatic cystic teratoma extending into the mediastinum in a 29-year-old woman which was succesfully managed with en-bloc distal pancreatectomy and spleenectomy.

Neuroendocrine Tumor Arising within Mature Cystic Teratoma of the Pancreas: Literature Review and Case Report

Cystic teratomas are germ cell tumors most commonly found in the ovaries and testes. The pancreas, however, is very rare as a site of occurrence. Moreover, only two cases of cystic teratoma with concomitant neuroendocrine tumor have been reported to date. We report the case of a 33-year-old female who presented with abdominal pain. Computed tomography and magnetic resonance imaging of the upper abdomen revealed an 85 mm cystic tumor in the head of the pancreas. Cystic teratoma and mucinous cystadenoma were suggested as differential diagnoses. Cytopathologic analysis of endoscopic ultrasound-guided fine needle aspiration was consistent with mucinous cystadenoma. Therefore, the patient underwent surgical resection. Histologic analysis revealed a mature cystic teratoma of the pancreas with a concomitant neuroendocrine tumor. The patient is in great condition at 8 months follow-up. Cystic teratoma of the pancreas with a concomitant neuroendocrine tumor is an extremely rare condition. Surgical resection remains the mainstay of treatment as it provides a definitive diagnosis and no recurrences have been reported to date.

[Mature teratoma of the anterior mediastinum with a predominance of the pancreatic component and signs of focal nesidioblastosis]

A case of a mature anterior mediastinal teratoma with a predominance of the pancreatic component (80% of the tumor) and signs of nesidioblastosis in a 46-year-old woman is presented. During histological examination, all components of the pancreatic parenchyma were determined - acini with interlobular and intralobular ducts, endocrine cells and islets of Langerhans of various sizes and shapes, as well as islet-duct complexes scattered in the acinar tissue. In addition to pancreatic tissue, cartilage, bronchial respiratory epithelium, small intestine tissue, hair follicles, and sebaceous glands were found in the neoplasm. Immunohistochemical examination revealed signs of focal nesidioblastosis. In the islets, insulin-positive β-cells (80.0% of the volume of the islets), as well as endocrine cells expressing glucagon and somatostatin (10.0% of the volume of the islets) were determined. By 2020, only 4 such cases have been published in the English-language literature.

Could the burden of pancreatic cancer originate in childhood?

The presence of pancreatic cancer during childhood is extremely rare, and physicians may be tempted to overlook this diagnosis based on age criteria. However, there are primary malignant pancreatic tumors encountered in pediatric patients, such as pancreatoblastoma, and tumors considered benign in general but may present a malignant potential, such as the solid pseudo-papillary tumor, insulinoma, gastrinoma, and vasoactive intestinal peptide secreting tumor. Their early diagnosis and management are of paramount importance since the survival rates tend to differ for various types of these conditions. Many pediatric cancers may present pancreatic metastases, such as renal cell carcinoma, which may evolve with pancreatic metastatic disease even after two or more decades. Several childhood diseases may create a predisposition for the development of pancreatic cancer during adulthood; hence, there is a need for extensive screening strategies and complex programs to facilitate the transition from pediatric to adult healthcare. Nevertheless, genetic studies highlight the fact the specific gene mutations and family aggregations may be correlated with a special predisposition towards pancreatic cancer. This review aims to report the main pancreatic cancers diagnosed during childhood, the most important childhood diseases predisposing to the development of pancreatic malignancies, and the gene mutations associates with pancreatic malignant tumors.

Management of oropharyngeal teratoma: Two case reports and a literature review

Pharyngeal teratomas are very rare congenital tumours derived from pluripotent stem cells. Surgical resection is the main treatment to avoid breathing and feeding difficulties. This current case report describes two newborn infants with congenital oropharyngeal teratomas. In one of the infants, the tumour presented along with a cleft tongue and cleft palate. Prenatal diagnosis by ultrasonography did not identify the tumours because the masses were small and there was no polyhydramnios. Both cases were treated surgically and histological examination of the masses in both cases confirmed the diagnosis of a congenital epignathus. There were no complications such as infection, bleeding or residual recurrence following surgery. After 1-year follow-up, there was no recurrence of the epignathus in either case. Oropharyngeal teratoma is a very rare congenital tumour that may cause upper airway obstruction and feeding difficulties in the newborn, so it should be treated surgically in a timely manner.