Infected and ruptured retroperitoneal teratoma

Abstract

DESCRIPTIONWe present images of an infected and ruptured retroperitoneal teratoma in an 8-month-old baby girl, who presented with a 2-week history of lowgrade intermittent fever and failure to thrive. On arrival at the hospital, she was lethargic, febrile and mildly dehydrated. The abdomen was distended with a palpable mass occupying the central abdomen and the left lumbar region.The white cell count and C reactive protein were elevated with measurement of 20.9 mg/dL and 6.27 mg/dL, respectively, indicating an underlying infection. Both tumour markers, α-fetoprotein (7.56 ng/mL) and β-human chorionic gonadotropin (<1.2 mlU/mL), were within normal limits. A sonographic study of the abdomen showed multiple intra-abdominal collections. The subsequent urgent abdominal CT revealed a relatively large left retroperitoneal cystic lesion with fatty and calcified components within (figure 1). The anterior wall of the lesion was disrupted and irregularly associated with multiple intraperitoneal collections. The overall appearances were compatible with a ruptured retroperitoneal teratoma.The patient underwent an emergency laparotomy with excision of the ruptured retroperitoneal tumour and drainage of the interloop intraperitoneal collections (figure 2). The final histopathological result confirmed that the mass was a benign mature teratoma.Retroperitoneal mature teratoma is a rare subgroup of teratoma. Tumour rupture and infection are known but rare complications of this tumour, which may result in significant morbidity if left untreated. Imaging plays an important role in the diagnosis of a mature retroperitoneal teratoma. Images in…Ultrasound is a low-risk modality, which is useful in paediatric population. However, the pitfalls of ultrasound are not capable of readily identifying calcifications, lack of anatomic resolution and operator dependent. 1 CT scan usually reveals complex appearance of the mature teratoma with internal debris, fat attenuation and distinct calcification. In addition, CT scan may depict the precise location of the tumour and the anatomic associations with the surrounding structures, which are important information for surgical planning.2 The disadvantages of CT are the risk of radiation, risk of intravenous contrast administration and relatively longer patient preparation.

Neonate with Retroperitoneal Mature Cystic Teratoma – A Case Report

“…Imaging plays a vital role in the diagnosis and management of teratomas. 6 Prenatal ultrasound may also provide valuable information for early diagnosis. 7 In our case, prenatal ultrasound was performed, but the final reports were not available.…”