Mature Cystitic Teratoma of the Bladder Masquerading as a Distal Ureteral Stone

10-cm mature cystic teratoma of the bladder in 48-year-old female misdiagnosed as bladder calculus: Management with robotic partial cystectomy

Cystic teratomas are a common ovarian neoplasm that are rarely found in other locations of the body, namely the sacrococcygeal region and anterior mediastinum. Localization to the urinary bladder is exceedingly rare, with only a few cases documented in the literature. Cystic teratomas are usually asymptomatic and found incidentally, but localization to the bladder can present as irritative lower urinary tract symptoms and/or mimic urinary tract calculi. We report the rare case of a mature cystic teratoma of the urinary bladder, presenting as foul-smelling urine with recurrent urinary tract infections and microhematuria, that was originally misdiagnosed as a bladder calculus.

Bladder teratoma with pilimiction in a male adolescent

Teratomas are tumors consisting of two or three germ layers, seen commonly during childhood. Mature teratomas are benign and demonstrate well differentiated tissues such as sebaceous glands, hair, and teeth. Bladder is a very rare extragonadal site for teratoma, moreover so in adults. Presentation may vary from with irritative lower urinary tract symptoms or urinary retention to pilimiction (passage of hair in the urine). We hereby present a case of mature teratoma of the urinary bladder, with a classical symptom of pilimiction, in a 22-year-old male patient, which to our knowledge is the first male case reported in the literature.

Mature teratoma of the bladder in adolescence: a case report and literature review

Background

Teratomas are tumors consisting of two or three germ layers, seen commonly during childhood. Teratomas have been reported to occur in various sites and organs. Bladder teratoma is a very rare extragonadal tumor, moreover in adults. Although teratomas are known as benign lesions in childhood, they may act as malignant tumors when detected during adulthood. This requires total tumor resection, particularly in adult cases, and the addition of radiotherapy and chemotherapy in cases with the potential of malignancy.

Case presentation

A very rare case of teratoma of the bladder in a 17-year old Asian girl is presented. The patient had chief complaints of hematuria. The diagnosis was made on cystoscopy and confirmed histopathologically. Complete excision was possible. To the authors’ knowledge, this is the first such case reported from Indonesia and the South East Asian region.

Conclusion

A bladder teratoma mimics the presentation of a bladder stone, clinically and radiologically. A dermoid cyst should be considered as a differential diagnosis, especially when the stone appears to be confined to the bladder wall during examination.