Images of interest. Hepatobiliary and pancreatic: mature cystic teratoma in the hepatoduodenal ligament

Teratoma in the Hepatoduodenal Ligament

A teratoma is not an uncommon tumor in the pediatric age group. It has a predilection for specific sites, but a teratoma arising from the hepatoduodenal ligament (HDL) is very rare. Only 15 cases of HDL teratoma have been reported so far. Due to the proximity to important structures, it is imperative that the correct anatomical localization is done preoperatively to avoid intraoperative surprises. Herein, we report a case of HDL teratoma in a toddler who underwent a successful excision. The relevant literature is also discussed briefly from a pediatric surgeon's perspective.

Hepatoduodenal ligament teratoma with immature elements

Pediatric germ cell tumors comprise 1-3% of all malignant pediatric tumors and are found in variable locations. We present the case of a term 3.7 kg neonate who was found to have a giant liver mass at birth, later determined to be an immature teratoma arising from the hepatoduodenal ligament. This case report and images add to the limited literature a very rare presentation of a teratoma.

Rare cause of abdominal incidentaloma: Hepatoduodenal ligament teratoma

The occurrence of a hepatoduodenal ligament teratoma is extremely rare, with only a few cases reported in the literature. This case report describes the discovery of a hepatoduodenal ligament lesion revealed during abdominal ultrasonography for cholelithiasis-related abdominal pain in a 27-year-old female. Cross-sectional imaging identified a 5 cm × 4 cm heterogeneous mass of fat tissue with irregular calcification located in the posterior-superior aspect of the head of the pancreas. An encapsulated lesion showing no invasion to the common bile duct or adjacent organs and vessels was exposed during laparotomy and resected. Intraoperative cholangiography during the cholecystectomy showed no abnormalities. The postoperative course was uneventful. Pathological analysis of the resected mass indicated hepatoduodenal ligament teratoma. This case report demonstrates that cross-sectional imaging, such as computed tomography, can reveal suspected incidences of this rare type of teratoma, which can then be confirmed after pathologic analysis of the specimen. The prognosis after complete surgical resection of lesions presenting with benign pathological features is excellent.

Primary teratoma of the lesser sac: lesser sac teratoma

Germ cell tumors predominantly involve the gonads but may rarely be found outside of the gonads, primarily in midline structures. We describe the case of a 27-year-old male with an asymptomatic 8 cm teratoma located within the lesser sac of his omentum. This is the fourth case of a teratoma located within the lesser sac of the omentum, which provides the opportunity to make some comparisons. Finally, we discuss some of the etiologic theories behind extragonadal germ cell tumors and how they relate to teratomas in the lesser sac.

Hepatoduodenal ligament teratoma with hepatic artery running inside

Teratoma in infants and children is not particularly rare. However, the teratoma in the hepatoduodenal ligament is extremely rare and the surgical treatment is challenging because of its anatomical complexity. We could find only six cases in the literature. In this report, we present the seventh case with special reference to the operative technique to save the hepatic artery for resection of the tumor using intraoperative ultrasonography.

Dermoid cyst in the hepatoduodenal ligament: report of a case

We report an unusual case of a mature cystic teratoma, or dermoid cyst, in the hepatoduodenal ligament of a young woman. Mature cystic teratomas are rarely found in extragonadal sites, especially the hepatoduodenal ligament. Surgical resection remains the mainstay of therapy and is required for a definitive diagnosis. Patients who undergo complete resection of a mature cystic teratoma normally have an excellent prognosis.