Malignant transformation of a mature teratoma in the duodenum: A case report.

INTRODUCTION

Mature teratomas of the duodenum are extremely rare, with only five cases reported in the English literature and none documented in Vietnam. Malignant transformation within a mature teratoma presents a challenging scenario for diagnosis and management, requiring a nuanced approach to treatment.

PRESENTATION OF CASE

We report the first documented case of malignant transformation in a duodenal mature teratoma in Vietnam. A 35-year-old male presented with persistent dull pain in the left flank, anorexia, and melena. Clinical examination revealed a palpable 10 × 14 cm mass in the left hypochondrium. Computed tomography (CT) imaging identified a tumor in the D4 segment of the duodenum with invasion into adjacent structures. The patient subsequently underwent surgical resection of the tumor, followed by adjuvant chemotherapy.

DISCUSSION

Histopathological analysis of the resected mass confirmed a moderately differentiated squamous cell carcinoma arising from a mature teratoma. Malignant transformations within teratomas, especially in such rare locations as the duodenum, require a multidisciplinary approach for optimal patient outcomes. In this case, the combination of surgical and adjuvant therapies was critical to managing the disease.

CONCLUSION

This case highlights the importance of early recognition and a multidisciplinary approach in managing malignant transformation in duodenal teratomas. The combination of surgery and adjuvant chemotherapy proved effective, with no recurrence or metastasis observed at five months follow-up.