Rare giant: mature cystic teratoma in the liver

Primary immature teratoma of the liver in an adult: Case report

Teratoma is an uncommon germ cell tumor and develops from at least 2 of the 3 germ cell layers: ectoderm, mesoderm, and endoderm. The origin of teratoma is primordial germ cells that migrate from the allantois to the gonadal ridges during embryogenesis. The teratomas can be intragonadal or extragonadal. Primary extragonadal teratoma is defined as if there is no evidence of a primary tumor in the testicles or ovaries. Common extragonadal sites include the anterior mediastinum, retroperitoneum, sacral region, and intracranial cavity. Primary intrahepatic teratomas are extremely rare, accounting for less than 1% of all teratoma cases. Hepatic teratomas are more common in children than in adults. We present a case of an immature primary hepatic teratoma in an adult woman.

Rare primary mature teratoma of the liver: A case report

BACKGROUND

Primary liver teratoma is an extremely rare tumor usually affecting children under the age of 3 years. Specific signs of teratoma on ultrasound, computed tomography (CT) or magnetic resonance imaging are lacking, which makes morphology the only diagnostic tool. Misdiagnosis of a mature teratoma may lead to excessive liver resection, whereas misdiagnosis of an immature teratoma may result in spread, causing a life-threatening condition. Consequently, a careful tumor examination is important, and the rarest types of tumors must be accounted for.

CASE SUMMARY

We describe a 52 years old female who presented with a solid mass in the left liver lobe. Contrast-enhanced CT and magnetic resonance imaging (MRI) revealed a round, heterogeneous lesion containing a number of fluid areas and areas of calcification in the middle, and the provisional diagnosis was cholangiocarcinoma. The patient underwent resection of liver segment I. Immunohistochemistry analysis of the resected lesion indicated thyroid follicular epithelium; however, the thyroid gland was intact. 10 years prior to presentation the patient underwent a surgery due to mature teratoma of the right ovary, nevertheless the tumor was benign and could not spread to the liver, in addition teratoma of the liver was also benign. This led to the final diagnosis of primary mature liver teratoma.

CONCLUSION

Primary hepatic teratoma, including heterotopia of the thyroid gland in the liver, is an extremely rare condition in adults that needs to be considered in the differential diagnosis of solid-cystic neoplasms in the liver and cholangiocarcinoma. This case adds to the limited literature on the patient presentation, clinical workup and management of liver teratomas.

Mature splenic teratoma: A rare case report

INTRODUCTION

Teratomas are germ cell neoplasms that can be malignant or benign. Their occurrence is more prevalent in gonads, but there are rare extragonal reports, and splenic teratomas are exceptionally uncommon.

CASE REPORT

A 44-year-old woman with a report of abdominal pain on the left flank for 12 h, was evaluated with TC that visualized spleen showing an oval, intraparenchymal, hypodense image with dense areas, submitted to conventional splenectomy, what identified mature cystic teratoma.

DISCUSSION

Dermoid cysts have nonspecific symptoms, usually related to extrinsic compression of other structures or rupture of the splenic capsule; the diagnosis is complex, since the alterations in imaging exams are not very specific. Thus, the confirmation is made through anatomopathological analysis.

CONCLUSION

Mature splenic cystic teratomas are rare and treatment should be evaluated according to the presence or absence of symptoms and diagnostic certainty.