Dermoid cyst of the pancreas: a case report with literature review

Successful laparoscopic resection for giant mature cystic teratoma of the pancreas: a case report and surgical refinements

BACKGROUND

Mature cystic teratomas or dermoid cysts of the pancreas complicate surgical approaches because of their anatomical position and ever-growing size. Herein, we report a case of a giant mature cystic teratoma of the pancreas that was successfully resected via complete laparoscopic distal pancreatectomy (LDP).

CASE PRESENTATION

A 39-year-old female patient was referred to our hospital for the evaluation of a pancreatic tumor. Three years of follow-up revealed that the tumor had increased in size to 18 cm, with hyperintense solid components on diffusion-weighted magnetic resonance imaging. Considering the possibility of malignancy, we decided to perform an LDP. The capsule appeared solid enough to withstand the retraction of the endoscopic forceps. Tumor size made it difficult to dissect the dorsal side of the tumor from the caudal to the cranial side. Early transection of the pancreas and additional ports facilitated dissection of the dorsal side of the tumor. We completed the LDP without intraoperative cyst rupture. On pathological examination, the tumor was diagnosed as a mature cystic teratoma originating from the pancreatic tail. The patient was discharged on postoperative day 13 with no complications.

CONCLUSION

LDP may be an option for surgical procedures in patients with large cystic lesions of the pancreatic body or tail. Intraoperative observation of the tumor and surgical refinement are necessary to complete the laparoscopic procedure without tumor rupture.

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.

Dermoid cyst of pancreas: A report of an unusual case

Introduction: Pancreatic dermoid cyst is a rare, benign germ cell tumour and part of differential diagnosis for cystic neoplasm of pancreas, where it shows a slight preference for the pancreatic head. Case Report: We report a case of dermoid cyst of pancreas in a 17-year-old female patient. Patient presented with epigastric pain, anorexia and lump in epigastric region. CECT showed a well marginated cystic lesion with tiny speck of calcification in wall and fatty component anteriorly in epigastric region in midline and towards right arising from anterior aspect of head of pancreas. The fat planes surrounding the lesion are normal. The CBD was seen lying on posterior aspect of the lesion. Conclusion: Pre-operative diagnosis is difficult and it is usually diagnosed intraoperatively or by histopathological examination of the specimen.

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.

Solid pancreatic masses in children: A review of current evidence and clinical challenges

Pancreatic tumors in children are infrequently encountered in clinical practice. Their non-specific clinical presentation and overlapping imaging characteristics often make an accurate preoperative diagnosis difficult. Tumors are categorized as epithelial or non-epithelial, with epithelial tumors further classified as tumors of the exocrine or endocrine pancreas. Although both are tumors of the exocrine pancreas, solid pseudopapillary neoplasm is the most prevalent solid pancreatic tumor in children, while pancreatoblastoma is the most common malignant tumor. Insulinoma is the most common pediatric pancreatic tumor of the endocrine pancreas. Malignant tumors require a complete, often radical, surgical resection. However, pancreatic parenchyma-sparing surgical procedures are utilized for benign tumors and low-grade malignancy to preserve gland function. This review will discuss the epidemiology, pathophysiology, clinical and diagnostic characteristics, and management options associated with both common and rare solid pancreatic masses in children. We will also discuss current challenges encountered in their evaluation and treatment.

Mature cystic teratoma of the pancreas with 30 years of clinical course: A case report

RATIONALE

Mature cystic teratoma of the pancreas is an extremely rare condition that is challenging to manage due to inadequate preoperative histological diagnosis.

PATIENT CONCERNS

A 36-year-old female was admitted to our hospital because of a complaint of worsening paroxysmal abdominal pain for over a year. She was diagnosed with pancreatic pseudocyst and underwent five surgical procedures (i.e., four external drainage and one internal drainage procedures) in the last 30 years.

DIAGNOSES

Intraoperative frozen section analysis identified the tumor as a cystic teratoma, and pathological evaluation confirmed it to be a mature cystic teratoma.

INTERVENTIONS

Explorative laparotomy was performed, and the tumor was then resected completely through with partial pancreatectomy, left colon resection, partial gastrectomy, duodenectomy, as well as inferior vena cava and renal vascular repair.

OUTCOMES

The patient exhibited a generally good wellbeing without any recurrence during the 6 months of follow up.

LESSONS

This case demonstrated the significant impacts of misdiagnosis and inappropriate treatments for benign disease on the patient's quality of life and highlighted the importance of early surgical resection with a definitive pathological diagnosis for pancreatic cystic teratoma.

Large Dermoid Cyst Presenting as Recurrent Pancreatitis

Pancreatic dermoid cysts are rare and benign congenital abnormalities of germ cell origin. They occur equally in males and females without age predilection. Though radiographic imaging aids in the diagnosis, most times they are inconclusive and require fine-needle aspiration cytology for confirmation. We report the first case of a dermoid cyst presenting as recurrent pancreatitis in a 49-year-old male. Computed tomography scan, followed by magnetic resonance imaging, showed a complex cystic mass lesion adjacent to the pancreatic tail. Endoscopic ultrasound noted a large heterogeneous cystic lesion with hypoechoic wall layers in the tail of the pancreas without invading surrounding structures. Fine-needle aspiration cytology revealed numerous mature squamous cells consistent with a pancreatic dermoid cyst. We discuss the history, clinical presentation, diagnosis, and treatment of pancreatic dermoid cysts.

Dermoid cyst of the pancreas: A rare cystic neoplasm

INTRODUCTION

Dermoid cyst of the pancreas, also called cystic teratoma, is a benign, well-differentiated, and extremely rare germ cell neoplasm. Preoperative diagnosis is challenging since there are no definitive preoperative diagnostic tests or pathognomonic findings.

PRESENTATION OF CASE

We report a case of a 54-year-old male who presented with an incidentally detected pancreatic cystic mass at the tail of the pancreas. Computerized tomography revealed a benign cystic mass such as oligocystic serous cystadenoma or a hemorrhagic cyst. However, a high CEA level from EUS guided aspirated fluid suggested mucinous cystic neoplasm. After laparoscopic spleen-preserving distal pancreatectomy, the final diagnosis was confirmed as a dermoid cyst of the pancreas.

CONCLUSION

Despite the benign nature of the dermoid cyst, complete surgical resection is mostly inevitable due to the difficulty of preoperative diagnosis as in the present case.