Singh Charan, Raypattanaik Niladri M, Sharma Ishan, Kaman Lileswar
General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.
Cureus. 2021 Jun 1;13(6):e15376. doi: 10.7759/cureus.15376. eCollection 2021 Jun.
Primary retroperitoneal teratomas are rare non-seminomatous germ cell tumors that arise from embryonal tissues. They form only 5%-10% of all retroperitoneal tumors. These are usually asymptomatic or present as lump or mass with compressive symptoms. Most of the patients are diagnosed by characteristic computed tomography findings. The chances of malignant transformation are rare. Complete surgical resection is the definitive treatment for most patients. We had a 19 years old young man, presented with pain abdomen and awareness of a lump in the right upper abdomen. Contrast-enhanced computed tomography (CECT) of the abdomen revealed a heterogeneous soft tissue mass in the retroperitoneum with calcification. He was successfully treated with en-bloc complete surgical resection. Histopathology confirmed benign mature teratoma including all three germ layers. The patient is doing fine at nine months of follow-up and planned for CECT abdomen. Primary mature teratomas arise in the retroperitoneum due to failure of germ cells migration to their normal location. Germ cells undergo differentiation into various germ layers. Teratomas can be classified as mature, immature, or non-dermal based on their histopathological characteristics. Although complete surgical excision is the mainstay of treatment, malignant teratomas frequently recur. So, annual follow-up is recommended with imaging. A classic mature teratoma requires careful examination and interpretation of the imaging. The amount of immature components determines outcome and recurrence in these patients so en-bloc surgical resection is the treatment of choice.
原发性腹膜后畸胎瘤是一种罕见的非精原细胞性生殖细胞肿瘤，起源于胚胎组织。它们仅占所有腹膜后肿瘤的5%-10%。这些肿瘤通常无症状，或表现为肿块并伴有压迫症状。大多数患者通过特征性的计算机断层扫描结果得以诊断。恶性转化的几率很低。对于大多数患者而言，完整的手术切除是决定性的治疗方法。我们有一名19岁的年轻男性，因腹痛和右上腹肿块感前来就诊。腹部增强计算机断层扫描（CECT）显示腹膜后有一个不均匀的软组织肿块并伴有钙化。他通过整块完整手术切除获得了成功治疗。组织病理学证实为良性成熟畸胎瘤，包含所有三个胚层。患者在随访9个月时情况良好，并计划进行腹部CECT检查。原发性成熟畸胎瘤发生于腹膜后是由于生殖细胞未能迁移至其正常位置。生殖细胞分化形成各种胚层。畸胎瘤可根据其组织病理学特征分为成熟型、未成熟型或非皮样型。尽管完整手术切除是主要的治疗方法，但恶性畸胎瘤经常复发。因此，建议每年进行影像学随访。典型的成熟畸胎瘤需要对影像学进行仔细检查和解读。未成熟成分的数量决定了这些患者的预后和复发情况，所以整块手术切除是首选的治疗方法。
