Excision of intra-abdominal mesenteric immature teratoma during COVID-19 pandemic

Abstract

The world is suffering from the COVID-19 pandemic. Nature has thrown a new challenge towards the healthcare professionals in the form of this new virus. As if that was not enough, we found an extremely rare, interesting and challenging case of mesenteric immature teratoma in this pandemic. Teratomas take origin from totipotent cells and may give rise to neoplasms that contain, in a helter-skelter fashion, bits of bone, epithelium, muscles, fat, nerves and other tissues. They are usually smaller than 10 cm, with cystic space, which is filled with a thick sebaceous secretion containing matted hair and sometimes teeth protruding from a nodular projection, which are unbrushed and may be carious. Though the usual sites are ovaries, occasionally testes, extragonadal sites may be affected. Classically the teratoma originates in the midline position. But in the abdomen, it usually takes the position of one of the paravertebral gutters, as in the present case, perhaps due to its size and weight of the solid part of the constituent elements. Due to its rarity it deserves the attention of the world and therefore we present to u this interesting case.

A huge mesenteric teratoma in reproductive age woman: a case report

“…Any abdominal mass which is freely mobile perpendicular to the attachment of mesentery is expected to be originating from mesentery itself. 5 But, because of huge size, the mass which fills the abdominal cavity completely may not show the usual pattern of mobility, as in this case. Usually, these mesenteric masses are painless.…”

“…1,5 Abdominal distension is the most common presentation and abdominal pain, if present, is because of the mass effect, leading to bowel obstruction or pressure symptoms over the bladder and sometimes hydro-ureteronephrosis. 1,5 Various sonographic features suggestive of dermoid cyst, include echogenic calcification in a cystic mass, cyst with fat fluid level, hyperechogenic lines and dots. 6,7 The site of origin in this case was difficult to diagnose by transabdominal or transvaginal sonography because of its huge size.…”