WOFAPS 2025 8th World Congress of Pediatric Surgery

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A rare case report of neonatal immature adrenal teratoma

Samir Hasan 1, Ülgen Çeltik 1, Eda Ataseven 2, Tülay Öztürk 3, Burçe Emine Dörtkardeşler 4, Gürdeniz Serin 5, Ahmet Çelik 1
1 Ege University Faculty of Medicine Hospital, Department of Pediatric Surgery, İzmir, Turkey
2 Ege University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology
3 Ege University Faculty of Medicine Department of Radiology, Division of Pediatric Radiology
4 Ege University Department of Pediatrics
5 Ege University Faculty of Medicine Department of Pathology

Introduction:
Adrenal teratomas are rare tumors that occur sporadically in the neonatal period, with most reported cases being mature teratomas. Immature variants are even less common and carry higher risks of recurrence and malignant transformation. To date, only one case of a perinatally diagnosed neonatal immature adrenal teratoma has been documented in the English literature. In this study, we aim to present the second reported case.

Case Report:

We present the case of a female neonate born at term with normal antenatal imaging findings. A right adrenal mass was incidentally detected on routine postnatal ultrasonography. Further imaging revealed a heterogeneous, predominantly cystic lesion with calcifications and mass effect on adjacent structures. Tumor markers, including alpha-fetoprotein (AFP), were within age-appropriate reference ranges. Surgical resection was performed at two months of age. Intraoperatively, a large adrenal mass displacing nearby organs was completely excised without complications. Histopathological examination confirmed a Grade 2–3 immature teratoma. The patient was scheduled for follow-up every three months by a multidisciplinary tumor board, including clinical, radiological, and biochemical surveillance. The patient is currently at the 6th postoperative month, with no evidence of recurrence during follow-up.

Conclusion:

This case represents the second reported neonatal immature adrenal teratoma and highlights the diagnostic challenges associated with such rare tumors. It underscores the importance of including adrenal teratomas in the differential diagnosis of perinatal suprarenal masses, particularly those that fail to regress.

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