Mature Cystic Teratoma: AIRP Best Cases in Radiologic-Pathologic Correlation

Intrapulmonary mature cystic teratoma: A case report with literature review

Background

Mature intrapulmonary cystic teratomas are rare. The clinical manifestations are nonspecific and may mislead to other diseases. The radiographic findings are often perplexing. There are few complete reports on intrapulmonary teratomas, including patient history, radiologic and pathologic findings, patient management, and outcomes. We present a case report of an intrapulmonary mature cystic teratoma diagnosed at our hospital, along with an extensive review of the relevant literature.

Case presentation

A 47-year-old non-smoking female patient presented with hemoptysis and intermittent dyspnea for 5 months without fever or weight loss. Chest computed tomography revealed an inhomogeneous, hypodense, lobulated mass with internal fat, calcification, and soft tissue components. The patient underwent a left thoracotomy and left upper lobe lobectomy. Pathological examination revealed a cystic tumor containing various components, including fat, keratin debris, teeth, and hair. A diagnosis of intrapulmonary mature cystic teratoma was made. Three months after the operation, no recurrent tumor was identified, and the patient was scheduled for follow-up next year.

Conclusion

Intrapulmonary mature cystic teratomas are unusual. Owing to its general clinical symptoms and radiographic findings, it was misdiagnosed before surgery. After surgery, pathological and radiological findings confirmed the diagnosis. Therefore, intrapulmonary mature cystic teratomas should be considered in the differential diagnosis, and sufficient examinations should be conducted to rule out the condition.

A Case Report of Intrapulmonary Mature Cystic Teratoma of the Lung

Introduction: Intrapulmonary mature cystic teratoma is an extremely rare form of extragonadal teratoma that frequently presents with nonspecific clinical and radiologic findings. The first case was described by Mohr in 1839. It usually involves the upper lobes of the left lung. Case Presentation: In this report, we describe the first case of a 28-year-old woman from Kabul, Afghanistan, who was diagnosed with intrapulmonary mature cystic teratoma in the left upper lobe and complained of dry cough and hemoptysis 6 months before her admission. Preoperatively, the clinicians suggested a diagnosis of lung abscess based on the symptoms and radiological findings. Postoperatively, the lesion was diagnosed as intrapulmonary mature cystic teratoma by anatomopathological examination. Conclusions: Intrapulmonary mature cystic teratomas are usually misdiagnosed preoperatively due to nonspecific clinical symptoms, and indistinguishable radiographic findings, and should keep in the differential diagnosis of all cystic lesions. An accurate diagnosis is made by postoperative anatomopathological examination, and complete surgical resection of the lesion is considered the optimal treatment.

Incidental Discovery of a Chronically Ruptured Ovarian Dermoid in a Patient With Right Upper Quadrant Pain

Ovarian neoplasms are categorized based on histopathologic features into epithelial surface cell tumors, germ cell tumors (teratomas), sex cord-stromal tumors, and metastases. Teratomas are the most common ovarian germ cell neoplasms. They are generally slow-growing lesions and can get fairly large before becoming symptomatic. The lesions are often incidentally discovered during imaging for other diagnostic purposes. Complications are uncommon but occur more commonly with larger lesions and include torsion, malignant degeneration, rupture, and rarely infection. When sizable, ovarian dermoid can rarely rupture and result in spillage of proteinaceous content into the peritoneal cavity, which can lead to chemical peritonitis. Additionally, the lesion can fragment into smaller lesions and can get implanted at different sites within the abdomen and pelvis. We present a case with an atypical presentation of a ruptured dermoid in a patient presenting with right upper quadrant pain who underwent sonographic evaluation, which demonstrated acute calculus cholecystitis but incidentally was found to have a partially calcified right subphrenic mass. Subsequent evaluation with computed tomography (CT) demonstrated multiple scattered peritoneal and mesenteric masses containing fat and calcification, highly suggestive of a chronically ruptured dermoid cyst.

Peritonitis From Ruptured Lipid-Poor Dermoid: Struma Ovarii

Mature cystic teratoma (MCT) is a common benign ovarian germ cell tumor. It is more predominantly seen in premenopausal women and contains at least two or more well-differentiated germ cell layers. It is termed a dermoid cyst if the ectodermal tissue is the predominant component. The complications of a dermoid cyst include torsion, malignant degeneration, rupture, and infection. The incidence of a ruptured dermoid cyst is around 1%-2% resulting in chemical aseptic peritonitis from spillage of the cyst contents. Usual clinical presentation is with diffuse abdominal or pelvic pain and abdominal distension. Around 93-96% of dermoid cysts demonstrate fat in the cyst cavity however, minimal or no fat poses diagnostic challenges. In this case, we discuss a rare case of spontaneously ruptured lipid-poor and thyroid tissue-rich left ovarian dermoid presenting with chemical peritonitis. Special magnetic resonance (MR) Imaging sequences such as fat saturation imaging, chemical shift imaging, and gradient-echo imaging assist in detecting scant amounts of fat in the cyst cavity or cyst wall.

Ovarian Torsion Due to Mature Cystic Teratoma During the Early Postpartum Period: A Rare Case Report

Mature cystic teratoma (MCT) is a benign and unilateral ovarian neoplasm usually seen in premenopausal women. Its most common complication, torsion, is a well-known cause of acute abdominal pain. However, it is rare in the early postpartum period. In this paper, we present a case of ovarian torsion due to MCT, which was diagnosed radiologically in the early postnatal period and surgically confirmed. A 25-year-old woman vaginally delivered a healthy baby on time and without any problems. She presented with acute abdominal pain in the right lower quadrant on the postpartum 5th day. Abdominal ultrasound (US) and computed tomography (CT) demonstrated an ovarian mass containing fat and calcification in the right adnexa and non-enhancing ovarian parenchyma. The patient was discharged on the 5th day after the salpingo-oophorectomy operation without any complications. US and CT provided crucial information to make an accurate and rapid management decision in ovarian torsion due to MCT.

Endobronchial teratoma: A systematic review of the literature with a case report

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Endobronchial teratoma is an extremely rare disease.

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Presentation could mimic bronchogenic cancer.

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Lobectomy or pneumonectomy is the treatment of choice.

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A brief review with a new case has been discussed.

Introduction

Endobronchial teratoma is sporadic disease. The study aims to present a case with endobronchial teratoma with a brief literature review. A 26-year-old male presented with a history of frequent attacks of chest infection for the last two years. Chest examination showed diffuse wheeze all over the left side of the chest. Chest x.ray showed opacification involving all of the left side of the chest with elevated left hemi diaphragm while computed tomography scan confirmed complete collapse of the left lung with consolidations and air bronchogram. Flexible bronchoscopy showed near-total obstruction of the left main bronchus. Under general anesthesia, left pneumonectomy was performed. The result of the histopathological examinataion showed mature teratoma.

Conclusion

Endobronchial teratoma is an exceedingly rare type of intrathoracic teratoma that mainly affects males and is usually diagnosed at the 3rd decade of life; lobectomy or pneumonectomy are optimal managements for these cases.

Mature cystic teratoma of the neck misdiagnosed at cystic hygroma; Case report

BACKGROUND

Teratomas arise from primordial germ cells which arrest during its migration from the hindgut allantois the gonads during the first weeks of gestational life, they may occur in both gonadal and extra-gonadal locations. They occur in 1/40,000 live births. The most common anatomical locations are the sacro-coccygeal region and the ovary, neck teratomas constituted about 1.5%. Malignant transformation has been reported.

CASE PRESENTATION

A 2-year-old boy presented with a gradually enlarging mass in the left side of the neck causing stridor and difficulties in respiration especially during sleep, the parents noticed difficulties during swallowing. The mass was misdiagnosed as cystic hygroma and the patient underwent 2 sessions of sclerotherapy with no improvement. Clinical examination showed a large mass in the left side of the neck which was multilobulated causing tracheal shift to the opposite side. There were no signs of inflammations over the mass. CT-scan showed evidence of enhancing multi-cystic lesion with multiple flecks of calcification. Complete surgical resection was done successfully and the histopathological study of the mass showed mature elements of ectodermal, mesodermal, and ectodermal germinal layers which was consistent with mature cystic teratoma. The follow up showed no postoperative complications.

CONCLUSION

Mature cystic teratoma of the neck is very rare and may be difficult to be differentiated both clinically and radiologically from other neck masses. The accurate diagnosis must be made before any kind of treatment is started. Complete surgical resection is the main management option and required to decrease the recurrence.

Intrapulmonary mature cystic teratoma of the lung: case report of a rare entity

Background

Intrapulmonary teratoma (IPT) is a rare type of extra gonadal teratoma which often presents with non-specific symptoms and can be misdiagnosed as other diseases. Here we report a patient with IPT which was initially misdiagnosed as lung hydatid cyst versus abscess.

Case presentation

We report an intrapulmonary teratoma in a 27-year-old female presenting with persistent chest pain and dyspnea since a few years prior to her admission with associated symptoms of cough and fever. Chest x-ray only showed left side massive pleural effusion and computed tomography scan of the lungs was suggestive of hydatid cyst or a lung abscess. She underwent lobectomy and postoperative histopathological study revealed IPT as the final diagnosis.

Conclusion

Due to the non-specific symptoms and rarity, IPT can be easily misdiagnosed at first. It is essential that physicians take into account the possibility of IPT when approaching a new case of lung mass.

Rare giant: mature cystic teratoma in the liver

Teratomas are rare pluripotent embryonic tumours occurring mostly in gonadal organs and pediatric age groups. Mature cystic teratoma in the liver are rare, and to the best of our knowledge, only a dozen cases in adults have been published in the literature. We present a 27-year-old female who had a history of loss of appetite and mild abdominal distention. Computed Tomography revealed a liver mass suggestive of teratoma. The patient underwent elective surgery, and the diagnosis of mature cystic liver teratoma was confirmed histologically. Measuring 23 cm in a longitudinal axis, the patient had an uneventful post-operative evolution and was discharged on day eight. Teratomas in the liver are a rare finding, especially in adults, mostly due to their asymptomatic evolution. Due to the possibility of malignant transformation, complete surgical resection remains the best treatment option.

Identification of a giant mediastinal teratoma by echocardiography: A case report

The diagnosis of mediastinal space-occupying lesions largely relies on X-ray and computed tomography. However, thanks to technological progress, transthoracic echocardiography can clearly display the mediastinal structures surrounding the heart and great vessels, thereby improving the detection rate of mediastinal space-occupying lesions. Primary mediastinal teratoma is relatively rare, and removal of giant mediastinal teratoma by thoracoscopic surgery has rarely been reported. Here, we report a case of giant mediastinal teratoma diagnosed by transthoracic echocardiography, which was treated by complete thoracoscopic resection and confirmed by histology.