Resection of ruptured hepatic teratoma in an adult

Abstract

HighlightsRare presentation of ruptured hepatic teratoma in an adult.<1% of teratomas are found to originate from liver and predominantly found in pediatric populations.Complete surgical resection is mainstay treatment.Definitive diagnosis is found on histopathological results.

Rare giant: mature cystic teratoma in the liver

“…Hepatic teratoma is a rare finding; to the best of our knowledge, only a small number of case reports are present in the literature, and no liver-specific treatment guidelines have been established [2, 4, 5]. The largest tumour recorded to date measured 27 cm in diameter [7].…”

“…It is believed that during the period of organogenesis, the arrest in migration along the urogenital ridge can lead to the development of teratomas in extra-gonadal sites; [1, 5] the hypothesis of re-implantation of ovarian teratoma in an extra-gonadal site has also been proposed. [4] MCT are known to have a slow growth rate (<2 mm/y) [8]. The characteristic imaging appearance of an MCT in CT is a cystic mass containing adipose sebaceous fluid, mostly unilocular with a distinct surrounding capsule, a differential diagnosis with other fat-containing liver masses including myelolipoma, lipoma, angiomyolipoma, and metastatic adipose tumour of the liver should be made [9].…”

“…Magnetic resonance imaging has also been proven to be a viable imaging modality, [2] while fluorodeoxyglucose (FDG) positron emission tomography has limited diagnostic use to the low FDG uptake presented by MCT [10]. The definitive diagnosis of MCT is possible through histological examination, characteristically containing variable amounts of calcification (56%) such as bone, teeth, hair or soft and fat (93%) neural tissue and rarely thyroid and pancreatic tissue [4, 8]. The presence of immature tissue in any of their germ layers influences an unfavourable prognosis, which is based on the histopathological features categorized in benign and malignant [5].…”

“…By definition, it must contain at least two of three germ layers: ectoderm, mesoderm and endoderm [2, 3]. To the best of our knowledge, <50 cases of primary hepatic teratomas have been reported, the majority in the pediatric age group, and only a dozen case reported for adults [4]. Encountered predominantly in the female population, [1, 5] teratomas possess distinctive imaging characteristics which allow accurate pre-operative diagnosis in most cases.…”

Dentigerous Equine Teratoma in a Stallion: Surgical Management and Clinicopathology

“…Teratoma is a rare embryonic tumor that can be both benign or malignant, most often diagnosed as benign. Teratoma is composed of mature somatic tissue that is not well organized and composed of neoplastic germ cells [ 1 ] originating from all three layers of embryonic germ cells: ectoderm, mesoderm and endoderm (ex: epithelium, brain, bone, cartilage) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. In human medicine these tumors that originate from all three germ layers are also called “tridermomas”; this term is not currently used in veterinary medicine.…”