33rd Annual Congress of Turkish Pediatric Surgical Association

S Arabul*, E Peştereli**, G Karagüzel*

*Akdeniz University School of Medicine Department of Pediatric Surgery, Antalya
**Akdeniz University School of Medicine Department of Pathology, Antalya

Extrgonadally located fetiform teratoma is an uncommon type of teratoma. Herein, we aimed to present a case of retroperitonealy located fetiform teratoma which was diagnosed at antenatal period.

The patient in whom a retroperitoneal mass was detected antenatal follow up was born at 35th week by ceserian section . At the postnatal follow-up, α- fetoprotein (AFP), abdominal ultrasonography and magnetic resonans (MR) imaging were obtained. AFP levels at first and 15th day of life were 57.362 and 9038ng/ml, respectively. Ultrasonography that was done in the first day of life revealed a 5x4x3 cm mass in surrenal region, including solid and cystic components (hamartoma? teratoma? cystic neuroblastoma?). After one month, it was measured as 8x4x7 cm. MR imaging represented a retroperitoneal mass which was well limited and showing heterogenous (hypo/hyperintens) structure, concordant with teratoma. The patient operated on when it was two months of age. Intraoperatively a cystic/solid mass including bone/cartilogenous tissiues and surrounded with a membrane was found that was adherent to surrenal gland, pushing liver superiorly and kidney inferiorly. The mass which was containing rudimentary parts of bowel and extremity was excised together with surrenal gland. Histopathological examination reported as fetiform teratoma which has no vertabral differantiation. Patient is under follow- up for one year without any complaint.

Differantial diagnosis of retroperitonealy located masses determined at antenatal period should include fetiform teratoma. Although MR is helpful in differantial diagnosis, histopathologic examination is important to distinguish fetiform teratoma from fetus- in-fetu. In fetiform teratoma , succesful results are obtained with close clinical follow- up and proper timing for surgery.

S Arabul*, E Peştereli**, G Karagüzel*

*Akdeniz Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı, Antalya
**Akdeniz Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı, Antalya

Ekstragonadal yerleşimli fetiform teratom nadir görülen bir teratom tipidir. Burada, antenatal dönemde tanı konulan retroperitoneal yerleşimli bir fetiform teratom olgusunun sunulması amaçlanmıştır. Antenatal takiplerinde retroperitoneal kitle saptanan hasta 35 haftalık olarak sezaryan ile doğmuştur. Postnatal izleminde α- fetoprotein (AFP), abdominal ultrasonografi ve magnetik rezonans (MR) görüntülemeleri yapılmıştır. AFP değerleri birinci ve 15’inci gün sırasıyla 57.362 ve 9.038 ng/ml olarak saptanmıştır. Postnatal birinci gün yapılan ultrasonografide, surrenal lojda  5x4x3 cm boyutlarında, 1 ay sonra ise  8x4x7 cm kistik ve solid komponentleri olan kitle (hamartom? teratom? kistik nöroblastom?) görülmüştür. MR görüntülemesinde heterojen (hipo/hiperintens) yapıda teratom ile uyumlu, iyi sınırlanmış bir retroperitoneal kitle saptanmıştır. Hasta iki aylıkken ameliyat edilmiştir. İntraoperatif değerlendirmede, surrenal beze yapışıklık gösteren, karaciğeri superiora, böbreği inferiora iten, sıvı dolu bir kese ile çevrili, içerisinde kemik/kıkırdak dokuların palpe edildiği bir kitle (9x8x5cm) görülmüştür. İçerisinde bağırsak ve ekstremite taslakları olan kitle, surrenal bez ile birlikte total olarak eksize edilmiştir. Histopatolojik değerlendirmede, vertebral farklılaşma saptanmamış olup bulgular fetiform teratom ile uyumlu olarak rapor edilmiştir.