A case of immature teratoma originating in intra-abdominal undescended testis in a 3-month-old infant

Teratomas in an undescended testis are rare in infants. This report was the youngest case of immature teratoma originating in intra-abdominal undescended testis. A 3-month-old infant with cryptorchism was seen because of an asymptomatic palpable mass in the right abdomen. Ultrasonography and computed tomography revealed a multicystic large tumor with focal calcifications in the right side and serum tumor markers within normal limits. Complete resection of the tumor was performed and the histopathological diagnosis was made as immature teratoma of the right testis. Because retroperitoneal lymph nodes metastasis was observed in 3-month follow-up postoperatively, retroperitoneal lymphadenectomy and chemotherapy including bleomycin, etoposide, and cisplatin were performed. Presently, the infant has been free of recurrence for 3 years. We suggest that nonpalpable testis should undergo a careful evaluation and prompt resolution and that the subsequent finding of an intra-abdominal mass should make us think on the possibility of intra-abdominal testicular germ cell tumor. Postoperative adjuvant chemotherapy in combination with complete resection of the tumor is necessary for pediatric immature teratomas originating in intra-abdominal undescended testis.     

Malignant gastric teratoma: case report

Gastric teratomas are rare and usually benign. A 4 month old boy presented with an abdominal mass and computed tomographic and ultrasound examination demonstrated a large multi-loculated tumour which was totally excised. The pathological diagnosis was of a malignant gastric teratoma and 12-month follow-up was uneventful.     

Spinal teratoma with pulmonary differentiation: a report of rare case and review of literature

The occurrence of intradural spinal teratomas in association with spinal dysraphism is uncommon and even rarer is pulmonary differentiation in a teratoma. We report a case of spinal dysraphism, duplication of lumbosacral spine, split cord malformation (SCM I), and meningomyelocele in an 8-month-old child. Excision of meningomyelocele and detethering of cord was done. Pathologic examination revealed a mature teratoma with pulmonary differentiation. To the best of our knowledge this is the second case of spinal teratoma with pulmonary differentiation.     

Paradoxical response of a pineal immature teratoma to combination chemotherapy

A case of primary intracranial germ cell tumour is reported in a 5-year-old Chinese boy who presented with symptoms and signs of increased intracranial pressure. Computed tomography (CT) scan of the brain revealed a multicystic tumour over the pineal region. Stereotactic biopsy yielded enteric epithelium and isolated cells with hyperchromatic nuclei and high nuclear-to-cytoplasmic ratio, suggesting the diagnosis of an immature teratoma. Grossly elevated serum and cerebrospinal fluid (CSF) levels of α-fetoprotein and mildly elevated levels of β human chorionic gonadotrophin suggested the simultaneous presence of embryonal tissues. Combination chemotherapy with cisplatin, etoposide, and bleomycin resulted in a gradual but complete normalisation of the serum and CSF tumour markers. Paradoxically, the patient's consciousness deteriorated and repeat CT scan after 3 months of treatment showed that the tumour was actually increasing in size. Complete surgical removal was attempted and histologic sections of the specimen revealed only mature teratomatous tissues. The child is now well and remains disease-free with minimal left hemiparesis 12 months after completion of treatment. This case illustrates the importance of combined neoadjuvant chemotherapy and surgery in the management of intracranial non-germinomatous germ cell tumour harbouring both germ cell and teratomatous components, while monitoring of both biochemical and radiological parameters are necessary in assessing the clinical behaviour of mixed germ cell tumours. © 1995 Wiley-Liss, Inc.     

A rare case of thymoma in a 15-month-old girl

We report a case of thymoma in a 15-month-old girl successfully treated with thymectomy. This case is unique due to the very young age of the child and a family history of thymoma in the father, who was treated with resection at age 10. Radiographic and CT findings mimicked thymic hyperplasia, and highlight the difficulty of distinguishing between these two conditions, since the latter is more common in children. The case is followed by a discussion of thymic hyperplasia and thymoma.     

Oral teratoma: a case report and literature review

Teratomas are true neoplasms composed of tissues from all three germinal layers. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 13 cases have been reported in the literature. We describe a male neonate with an oral teratoma originating from the anterior hard palate that was successfully treated with surgery.     

A rare case of inguinolabial lipoblastoma in a 13-month-old female

Lipoblastoma is a rare, rapidly growing, benign mesenchymal tumor composed of various stages of maturing adipocytes that most often occurs in children under the age of 3. The common locations are the extremities and the trunk. Presentation in the genitoinguinal area is rare. We report a case of a 13-month-old female infant with a 4-month history of a progressively enlarging left labial mass that encompassed her left labium majora and inguinal region. Pelvic MRI confirmed growth from previous ultrasound size of 3 × 2 × 1 cm to 7 × 2 × 2 cm. Composition was suggestive of adipose tissue. The mass was excised through a left inguinal incision. The final pathology results described a lipoblastoma. Six year follow-up has not revealed any signs or symptoms of recurrence.Circumscribed lipoblastomas should be distinguished from their infiltrative counterpart, diffuse lipoblastoma or lipoblastomatosis, which can be more difficult to excise and thus, more likely to recur. Lipoblastoma should also be distinguished from myxoid liposarcoma, which has malignant features, carries a high risk of recurrence, and requires a more aggressive management protocol. Although rare, lipoblastoma should be considered as part of the differential diagnosis of a rapidly growing vulvar mass in prepubertal children.     

3q27 aberrations in a childhood ovary teratoma with associated malignant germ cell component

Cytogenetic studies of childhood ovary tumors have been poorly described. In the present article, the cytogenetic findings of an ovarian teratoma with malignant germ cell (yolk‐sac) component occurring in an 8‐year‐old female are detailed. GTG‐banding showed a karyotype of 46,XX, t(3;20)(q27;q13.3) [4]/46,XX, del3q27 [3]/46,XX [30]. Previous studies have demonstrated common sites of loss of heterozygosity at 3q27‐q28 region in different types of cancer, suggesting the presence of tumor suppressor genes within this region. Pediatr Blood Cancer 2009;52:398–401. © 2008 Wiley‐Liss, Inc.     

Clear cell sarcoma of the kidney in a 4-month-old infant: A case report

A case of clear cell sarcoma of the kidney is described in a 4-month-old male infant. The tumor had a typical histological pattern, consisting of sheets of tumor cells possessing “empty” nuclei set within a delicate capillary network. There was extensive necrosis and tumor cell cytoplasm contained vimentin. This tumor occurs only rarely in infants less than six months of age. The different renal neoplasms of childhood have diverse prognoses and demand specific therapy so that accurate diagnosis is mandatory. The present case illustrates that clear cell sarcoma, a highly malignant neoplasm, must be considered in the differential diagnosis of a renal mass occurring in this age group. © 1993 Wiley-Liss, Inc.     

Immature ovarian teratoma with peritoneal gliomatosis and elevated serum alpha-fetoprotein associated with a second mature teratoma

A 7-year-old girl had a huge immature grade 2 teratoma of the left ovary with peritoneal gliomatosis and elevated serum alpha-fetoprotein (AFP). The serum AFP level reached 3543 ng/ml and returned to normal after left salpingo-oophorectomy and chemotherapy. Twenty-two months later, a second mature teratoma was removed from the left subdiaphragmatic region. The AFP level had been within the normal range and the patient had been symptom-free for 3 years following the previous operation. AFP was positive in the tubular epithelium of the immature tissues on immunohistochemical study. Offprint requests to: A. Hokama     

Gastric teratoma with thoracic extension in a 2-year-old boy

A case of gastric teratoma with intrathoracic extension in a 2-year-old boy is reported with a brief review of the literature. Offprint requests to: R. Shanthaveerappa     

Recurrent yolk sac tumor following resection of a neonatal immature gastric teratoma

Gastric teratomas are very rare and usually benign. Only a few cases of gastric teratomas with malignant components have been reported. This report describes recurrence of a yolk sac tumor following resection of a neonatal immature gastric teratoma. Gastric teratoma recurring as a malignant lesion has not been previously reported. Recurrence of immature gastric teratomas should be considered, and a periodic follow-up check with alpha-fetoprotein level should be mandatory.     

Sacrococcygeal teratoma: the 13-year experience of a tertiary paediatric centre

Aim: To describe the management, morbidity and mortality of infants admitted to a tertiary paediatric hospital in New South Wales, Australia with a diagnosis of sacrococcygeal teratoma (SCT). Methods: All neonates admitted to the neonatal intensive care unit with a SCT between January 1996 and December 2008 were included in this retrospective review. Data collected included maternal and neonatal demographics, time of diagnosis, tumour characteristics, surgical treatment, operative complications and outcomes. Results: Seventeen infants with a diagnosis of SCT were included in the study. Of these infants, the majority (70%) were born at term, and eight had a prenatal diagnosis made during the second trimester. Associated anomalies were detected in seven infants (41.8%), with renal anomalies being the most common. Tumour histology included mature (50%, n= 8), yolk sac tumour (18.75%, n= 3), immature (6.25%, n= 1) and mature with mixed elements (25%, n= 4). Recurrent disease occurred in two infants within 4–18 months of the primary resection, with one infant suffering a second recurrence. Only one child died prior to surgery, giving a survival rate of 94%, and mean age at follow‐up was 32 months. Long‐term sequelae found in four babies included revision of scar, vesicoureteric reflux, post‐surgical neurogenic bladder and osteotomy for hip dysplasia. Conclusions: The overall survival of neonatal SCT is high. While this is a small series, our results are consistent with the literature. Important components of management include timely diagnosis, multidisciplinary planning, long‐term follow‐up and intervention for functional sequelae.     

Malignant teratoma of the greater omentum

A 9-year-old girl with a malignant teratoma of the greater omentum is presented. The main presenting symptoms and signs were mild abdominal pain and a palpable abdominal mass. Exploratory laparotomy revealed a huge tumor occupying the peritoneal cavity and stemming exclusively from the greater omentum. This case represents an uncommon site of development of a malignant teratoma and may be the only one in the literature.     

Life-threatening mediastinal teratoma in a neonate

 This report describes a newborn with a large mediastinal teratoma (MT) presenting with severe respiratory distress (RD) at birth. At operation, there was no space for dissection because the huge cystic and solid tumor completely occupied the left hemithorax. After evacuation of the cystic component, the tumor was removed successfully. To our knowledge, only 16 newborn infants with MT presenting with RD have been reported. Operative morbidities occurred in one-half of the cases. We have reviewed the literature to discuss the potential risks of this entity. Accepted: 17 February 2000     

Management of benign sacrococcygeal teratoma: reducing mortality and mornidity

Between 1954 and 1987, 43 children with sacrococcygeal teratoma have been seen in our institution. There was 1 stillbirth, 4 neonates (9%) died during transfer, and there were 2 operative deaths (4.5%). Median age at operation was 4 days (range 1 day to 3 years). The survivors have been followed up for a median of 5.5 years (range 5 months to 32 years). Four patients have faecal and/or urinary incontinence. One developed a malignant teratoma subsequent to excision of a benign tumour. Since 1982, 4 patients have been diagnosed by antenatal ultrasound scanning, there have been no deaths related to sacrococcygeal teratomas either during transit or at operation, and morbidity has been minimal. Increasing use of antenatal ultrasound and improved neonatal anaesthetic and surgical care are the main contributory factors.