Primary adrenal teratoma: Clinical characteristics and retroperitoneal laparoscopic resection in five adults

Abstract

Abstract. Primary adrenal teratoma is extremely rare. To investigate the clinical characteristics and further enrich the limited knowledge on its diagnosis and treatment, the present study retrospectively analyzed the detailed clinical data of five patients with primary adrenal teratomas treated in the Peking Union Medical College Hospital (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China) between March 2009 and February 2014. The five patients were female, aged from 16 to 51 years (mean, 36.0±16.3 years), with solitary lesions that were incidentally found on routine physical examinations. The tumor size ranged from 2.4 to 9.0 cm (mean, 6.0±2.7 cm). Ultrasonography revealed a mixed echo in four patients, and computed tomography showed mixed density masses with fat components and calcification in three patients. Adrenal-related endocrine tests were normal in all five patients, and no abnormalities were found in the three patients who underwent somatostatin receptor scintigraphy examination. All patients were treated with retroperitoneal laparoscopic surgery, with no complications, and the resected tumors were identified as mature cystic teratomas pathologically. To date, the patients have been followed up for 4-60 months post-operatively, with no recurrence. In conclusion, this rare adrenal teratoma is an occult entity to which reproductive females are susceptible. The tumor exhibits no typical clinical manifestations or adrenal-related laboratory abnormalities, and the pre-operative diagnosis mainly relies on imaging characteristics of a heterogeneous lesion containing fat components with scattered and marginal calcifications. The preferred treatment is retroperitoneal laparoscopic surgery, and the prognosis is good.

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

“…In 2014, Zhou and coworkers in their 31-year study showed 2 adrenal teratomas, which comprised 2.7% of adrenal lipomatous tumours (Zhao et al 2014). The other large series was by Li and coworkers who reported 5 adrenal teratomas and the prevalence of the lesion in adrenal diseases in a 5-year period is 0.13% (Li et al 2015b).…”

Giant retroperitoneal teratoma displacing kidney causing acquired crossed non-fused renal ectopia: rare case report

“…Till now the maximum size reported in literature is of mature cystic teratoma in a 33 yr old lady, extending from pancreas upto pelvis about 35x35cm size (weight not mentioned) and of 22x17x7cm size and 1.6kg weight, in a 39 yr old lady, at rt adrenal region. 5,8 Considering volume-33,750cm 3 , weight 12kg vs age of patient the case is probably largest ever reported in a child as young as 15 yrs of age. There was 10kg fluid and 2kg solid mass in tumor ( Figure 5).…”

“…There are reports of laparoscopic /retroperitoneoscopic resection of adrenal teratoma. 8,9 In this case tumor was not originating from adrenal gland. Although author do laparoscopic surgery for G I tract tumors, but the approach varies case to case.…”

Feocromocitoma assintomático em uma paciente jovem com incidentaloma adrenal

“…A clínica é muito variável, de manifestações severas e dramáticas em alguns casos raros, como o reportado, a mínimas ou sem qualquer sintomatologia em outros, elevando de forma dramática a mortalidade. As manifestações clínicas, quando presentes, são relacionadas com a liberação pontual de catecolaminas na circulação, variando, desta forma, proporcionalmente à quantidade de catecolaminas (Li et al, 2015).…”