Pace Spencer, Sacks Marla A, Goodman Laura F, Tagge Edward P, Radulescu Andrei
School of Medicine, Touro University California, Vallejo, CA, USA.
Department of Surgery, Division of Pediatric Surgery, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
Am J Case Rep. 2021 Feb 11;22:e929247. doi: 10.12659/AJCR.929247.
BACKGROUND Teratoma, a tumor containing a variety of tissues, is a broad diagnosis containing mature teratoma, immature teratoma, and teratomas with malignant transformation. The tumor forms during embryological development secondary to unsuccessful migration of primordial germ cells. A specific type of mature teratoma, containing human-like features, is called a fetiform teratoma. The fetiform teratoma is often compared and confused with fetus in fetu, a reabsorbed twin. While these tumors have commonly been described in the gonads, the retroperitoneal location finding on antenatal imaging is rare. The distinction between the aforementioned subtypes is not well established, proving a challenging diagnosis prior to resection. CASE REPORT We present a case of a newborn male with a prenatal diagnosis of retroperitoneal cystic mass. Although prenatal imaging was obtained, the diagnosis remained unclear. After birth, planned surgical excision on day of life 7 showed the suprarenal mass contained contiguous intestinal elements. Histopathology examination revealed a mature cystic teratoma with multiple tissue types, including colonic, brain, respiratory, lymphatics, and nerves, reminiscent of fetiform teratoma. This case report presents an interesting example of differentiating elements straddling the diagnoses mentioned above. CONCLUSIONS This is the first reported case of fetiform teratoma diagnosed in a newborn and is especially unique for having the element of intestinal duplication within the retroperitoneal mass. The differentiating features of fetus in fetu and fetiform teratoma depend on subjective distinctions. The case provides an opportunity to discuss the differentials and management strategies.
背景 畸胎瘤是一种包含多种组织的肿瘤，是一个宽泛的诊断，包括成熟畸胎瘤、未成熟畸胎瘤以及发生恶性转化的畸胎瘤。该肿瘤在胚胎发育过程中形成，继发于原始生殖细胞迁移失败。一种含有类人特征的特定类型的成熟畸胎瘤被称为胎儿样畸胎瘤。胎儿样畸胎瘤常与胎内胎（一种吸收不全的双胎）相比较并混淆。虽然这些肿瘤常见于性腺，但产前影像学检查发现其位于腹膜后位置的情况罕见。上述亚型之间的区别尚未明确确立，在切除前的诊断具有挑战性。病例报告 我们报告一例产前诊断为腹膜后囊性肿物的新生儿男性病例。尽管进行了产前影像学检查，但诊断仍不明确。出生后，计划在出生后第7天进行手术切除，结果显示肾上腺肿物包含相连的肠管成分。组织病理学检查显示为成熟囊性畸胎瘤，含有多种组织类型，包括结肠、脑、呼吸道、淋巴管和神经，类似于胎儿样畸胎瘤。本病例报告展示了一个跨越上述诊断的鉴别诊断的有趣例子。结论 这是首例报道的新生儿期诊断的胎儿样畸胎瘤病例，尤其独特之处在于腹膜后肿物内存在肠重复畸形成分。胎内胎和胎儿样畸胎瘤的鉴别特征取决于主观区分。该病例提供了一个讨论鉴别诊断和管理策略的机会。
