May 2022, Volume 72, Issue 5

IMAGING CORNER

A 17-year-old girl with massive Intra-abdominal Germ Cell Tumour

Palwasha Rehman  ( Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan )

Abstract

Teratomas comprise of three germ layers. Mature cystic teratomas are the most common among them. Due to cystic and solid components the radiological presentation varies. Even today surgical resection is the treatment of choice for mature teratoma. We share the case of a 17-year old girl with massive abdominal distension; subsequently diagnosed with mature teratoma.

 

Keywords: Adolescent, Abdomen, Teratoma.

 

DOI: https://doi.org/10.47391/JPMA.22-67

 

A 17-year-old girl presented with significant abdominal distension which had progressively increased in size over the past 2 years. On examination there was thin emaciated girl with massive abdominal distension; abdominal girth of 106cm. An abdominal mass was palpable which was firm to hard in consistency. Serum markers were slightly raised, alpha-feto-protein was 2254 IU/ml.

CT scan abdomen and pelvis revealed huge mass with solid and cystic components approximately 40 x 32 cm in size that occupied the whole abdominal-pelvic cavity (Figure). There were patchy dense calcifications within the mass that showed post contrast enhancement. Peritoneal deposits along with ascites were also noted. Ultrasound guided biopsy of the mass revealed a tumour composed of mature cartilage, respiratory epithelium, adipose tissue and a small focus of glial tissue. She was diagnosed with mature teratoma. Whole body bone scan showed mild diffuse uptake in the abdominopelvic mass with no osseous lesions.

 

 

Teratomas are rare tumours, that are characterized by well-differentiated tissue parenchymas.1 The presentation of mature teratoma varies radiologically from cystic mass to a complex cyst with solid component.2 The presenting complaints mainly are pain, swelling or bleeding. Many times, they remain asymptomatic and attain a huge size such as in our case. Surgical resection is the best treatment approach for mature teratoma, 3 unfortunately in our patient because of the massive tumour presentation, surgical resection was not possible.

 

Disclosure: There is no conflicts of interest.

 

References

 

1.       Hoang VT, Trinh CT, Le TB, Le TK. Recurrence of retroperitoneal mature cystic teratoma in an adult: A case report. Radiol Case Rep. 2019;14:692-696.

2.       Sahin H, Abdullazade S, Sanci M. Mature cystic teratoma of the ovary: a cutting edge overview on imaging features. Insights Imaging. 2017;8:227-241.

3.       Sinha A, Ewies AA. Ovarian Mature Cystic Teratoma: Challenges of Surgical Management. Obstet Gynecol Int. 2016;2016:2390178.

 

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