Rathod Jignesh, Patel Sujan, Barot Ketul S, Naik Saloni H, Bhatt Ravi, Chotaliya Jay
Department of General Surgery, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India.
Pramukhswami Medical College, Karamsad, Anand, Gujarat, India.
Int J Surg Case Rep. 2021 Apr;81:105775. doi: 10.1016/j.ijscr.2021.105775. Epub 2021 Mar 16.
Teratoma is a rare clinical entity in adults and commonly arises from gonads. Being rare, retroperitoneal teratomas account for 4 % of all primary teratomas. A teratoma can be mature or immature, of which mature is more common in adults and immature is more common in neonates or children. It is labeled immature if at least one from the three germ layers lacks differentiation. To the best of our knowledge, this is the first case of primary retroperitoneal 'immature' teratoma in a male adult.
A 53-year-old male, following a road traffic accident, was investigated for the same and was incidentally detected with a retroperitoneal mass based on Chest X-ray, USG abdomen, and CT scan reports.
A painless palpable mass was identified on examination after the patient was referred to our tertiary care hospital for surgical benefit. AFP, HCG and LDH were tested and reported normal.
An exploratory laparotomy was done and the mass was surgically removed and sent for histopathological examination, which revealed an 'immature' retroperitoneal teratoma. After resection, a rent was identified in the IVC, following which the IVC was clamped. On follow-up, the patient has been compliant and the prognosis is good.
Retroperitoneal teratoma is a very rare clinical entity in adults. Being such massive, it can remain asymptomatic to be detected incidentally. Diagnosis is made with help of radiological findings and can be confirmed after surgical resection and histopathological examination. Surgery remains the mainstay of treatment.
畸胎瘤在成人中是一种罕见的临床病症，通常起源于性腺。由于罕见，腹膜后畸胎瘤占所有原发性畸胎瘤的4%。畸胎瘤可分为成熟型或未成熟型，其中成熟型在成人中更为常见，未成熟型在新生儿或儿童中更为常见。如果三个胚层中至少有一个缺乏分化，则被标记为未成熟型。据我们所知，这是首例成年男性原发性腹膜后“未成熟”畸胎瘤病例。
一名53岁男性在发生道路交通事故后接受检查，基于胸部X光、腹部超声和CT扫描报告，偶然发现腹膜后肿块。
患者被转诊至我们的三级护理医院以获得手术益处，检查时发现一个无痛性可触及肿块。检测了甲胎蛋白（AFP）、人绒毛膜促性腺激素（HCG）和乳酸脱氢酶（LDH），报告结果正常。
进行了剖腹探查术，手术切除肿块并送去做组织病理学检查，结果显示为“未成熟”腹膜后畸胎瘤。切除后，发现下腔静脉有一处撕裂，随后夹住下腔静脉。随访时，患者情况良好，预后良好。
腹膜后畸胎瘤在成人中是一种非常罕见的临床病症。如此巨大的肿瘤可能无症状，偶然被发现。借助影像学检查结果进行诊断，手术切除和组织病理学检查后可确诊。手术仍然是主要的治疗方法。
