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Teratoma of the adrenal gland: clinical experience and literature review.

ABSTRACT: Teratoma originates from pluripotent cells of two or more than two germ cell layers, and most of them are benign. Teratomas are found in the ovaries and testes. Retroperitoneal teratoma is rare, especially adrenal teratoma. Here, we describe a rare case of a 17-year-old woman who was diagnosed with pulmonary tuberculosis and a right adrenal mass at the age of eight. So, she received anti-tuberculosis treatment. Nine years later, chest X-rays showed prior lesions in both lungs, and abdominal CT showed the mass in the right adrenal gland was larger than before, during this period she had no clinical symptoms. She underwent retroperitoneal laparoscopic adrenalectomy, and the pathological diagnosis was a mature teratoma of the right adrenal gland. During a one-year follow-up, the patients recovered well without any discomfort. Thirty-two cases were found in the literature review, among which no patients had a history of pulmonary tuberculosis. Adrenal teratoma is often seen in females and the left adrenal gland. The imaging features of adrenal teratoma can be cystic, solid, and cystic solids. Mature fat and calcification can be seen in most teratomas. Comprehensive analysis of clinical features and imaging characteristics can enhance the diagnostic confidence of radiologists in adrenal teratoma.

SUBMITTER: He C

PROVIDER: S-EPMC7475358 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Teratoma of the adrenal gland: clinical experience and literature review.

He Cheng C Yang Yanli Y Yang Yang Y Wang Fuqin F Hu Jie J Zhang Jingjing J Yin Yu Y Zeng Lili L Zhang Tijiang T Liu Heng H

Gland surgery 20200801 4

Teratoma originates from pluripotent cells of two or more than two germ cell layers, and most of them are benign. Teratomas are found in the ovaries and testes. Retroperitoneal teratoma is rare, especially adrenal teratoma. Here, we describe a rare case of a 17-year-old woman who was diagnosed with pulmonary tuberculosis and a right adrenal mass at the age of eight. So, she received anti-tuberculosis treatment. Nine years later, chest X-rays showed prior lesions in both lungs, and abdominal CT s ...[more]

PMID: 32953615

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Project description:BackgroundIntracranial teratoma represents a rare neoplasm, occurring predominantly during childhood. Characteristic symptoms depend on the location but are mainly hydrocephalus, visual disturbances, hypopituitarism, and diabetes insipidus. Initial diagnosis can be challenging due to similar radiological features in both teratomas and other lesions such as craniopharyngiomas. Gross total resection is recommended if feasible and associated with a good prognosis.Case descriptionA 10-year-old girl presented with newly diagnosed growth retardation, fatigue, cephalgia and bilateral hemianopia. Further laboratory analysis confirmed central hypothyroidism and hypercortisolism. Cranial magnetic resonance imaging showed a cystic space-occupying lesion in the sellar and suprasellar compartment with compression of the optic chiasm without hydrocephalus present, suspicious of craniopharyngioma. Subsequently, an endonasal endoscopic transsphenoidal near-total tumor resection with decompression of the optic chiasm was performed. During postoperative recovery the patient developed transient diabetes insipidus, the bilateral hemianopia remained unchanged. The patient could be discharged in a stable condition, while hormone replacement for multiple pituitary hormone deficiency was required. Surprisingly, histopathology revealed conspicuous areas of skin with formation of hairs and squamous epithelia, compatible with a mature teratoma.ConclusionsWe present an extremely rare case of pediatric sellar teratoma originating from the pituitary gland and a review of literature focusing on the variation in presentation and treatment. Sellar teratomas are often mistaken for craniopharyngioma due to their similar radiographic appearances. However, the primary goal of treatment for both pathologies is to decompress eloquent surrounding structures such as the optic tract, and if applicable, resolution of hydrocephalus while avoiding damage to the pituitary stalk and especially the hypothalamic structures. If feasible, the aim of surgery should be gross total resection.

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Teratoma of the adrenal gland: clinical experience and literature review.

Publications

Teratoma of the adrenal gland: clinical experience and literature review.

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