Shadrack Mathayo, Ali Salma Juma, Andrea Richard Seleman, Bokhary Zaituni, Ngotta Victor, Ngiloi Petronila
Muhimbili University of Health and Allied Science (MUHAS), P.O. box 65001, Dar es salaam, Tanzania; Department of Pediatric Surgery, Muhimbili National Hospital (MNH), P.O. Box 65000, Dar es salaam, Tanzania; Department of Pediatric Surgery, Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Kilimanjaro, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Kilimanjaro, Tanzania.
Muhimbili University of Health and Allied Science (MUHAS), P.O. box 65001, Dar es salaam, Tanzania; Department of Pediatric Surgery, Muhimbili National Hospital (MNH), P.O. Box 65000, Dar es salaam, Tanzania; Department of Pathology, Muhimbili National Hospital (MNH), P.O. Box 65000, Dar es salaam, Tanzania.
Int J Surg Case Rep. 2025 May;130:111285. doi: 10.1016/j.ijscr.2025.111285. Epub 2025 Apr 12.
Mature teratomas are benign germ cell tumors that predominantly occur in gonadal regions. Extra-gonadal teratomas, especially in the umbilical region, are rare and often present significant diagnostic challenges. A delayed presentation with umbilical perforation in absence of congenital abdominal wall defects is uncommon.
A 9-year-old female presented with a four-year history of progressively enlarging umbilical mass with occasional discomfort. Examination revealed a firm, pedunculated mass protruding through a perforated umbilicus. A contrasted CT scan, revealed a well-encapsulated heterogeneous mass containing calcifications, with no evidence of deep intra-abdominal involvement. Complete surgical excision of the tumor was performed. Histopathological analysis confirmed a mature teratoma. Recovery was uneventful, and follow-up showed no recurrence.
Umbilical teratomas are rare entities, particularly in children without congenital abnormalities. This case illustrates delayed presentation of umbilical perforation and diagnostic challenges in unusual located teratoma, emphasizing the need for high suspicious index when evaluating persistent umbilical masses. Radiology plays a critical role in differentiating these tumors from other conditions like granulomas, infections, or congenital anomalies. Complete surgical excision is the treatment of choice.
This report highlights the rarity and diagnostic complexity of mature teratomas in atypical locations. Early recognition of this rare differential diagnosis in cases of persistent umbilical symptoms is essential to prevent complications such as infection and perforation. Awareness and early intervention are critical to achieving favorable outcomes in such cases. This case contributes to the limited literature on extragonadal teratomas with umbilical perforation and the need for timely diagnosis and management.
成熟畸胎瘤是主要发生在性腺区域的良性生殖细胞肿瘤。性腺外畸胎瘤，尤其是发生在脐部的，较为罕见，且常常带来重大的诊断挑战。在没有先天性腹壁缺陷的情况下出现脐部穿孔的延迟表现并不常见。
一名9岁女性，有一个逐渐增大的脐部肿物，伴有偶尔不适，病史4年。检查发现一个坚实的、有蒂的肿物从穿孔的脐部突出。增强CT扫描显示一个边界清晰的异质性肿物，含有钙化，没有腹腔深部受累的证据。对肿瘤进行了完整的手术切除。组织病理学分析证实为成熟畸胎瘤。恢复过程顺利，随访显示无复发。
脐部畸胎瘤是罕见的实体，特别是在没有先天性异常的儿童中。本病例说明了脐部穿孔的延迟表现以及不寻常部位畸胎瘤的诊断挑战，强调在评估持续性脐部肿物时需要有高度的怀疑指数。放射学在将这些肿瘤与其他疾病如肉芽肿、感染或先天性异常区分开来方面起着关键作用。完整的手术切除是首选的治疗方法。
本报告强调了非典型部位成熟畸胎瘤的罕见性和诊断复杂性。对于持续性脐部症状的病例，早期识别这种罕见的鉴别诊断对于预防感染和穿孔等并发症至关重要。认识和早期干预对于在此类病例中取得良好结果至关重要。本病例为关于伴有脐部穿孔的性腺外畸胎瘤的有限文献以及及时诊断和管理的必要性做出了贡献。
