Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old...

7182019 Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old Male a Case Report and Literature Review

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Hindawi Publishing CorporationCase Reports in Oncological MedicineVolume 983090983088983089983091 Article ID 983094983089983088983090983096983088 983093 pageshttpdxdoiorg983089983088983089983089983093983093983090983088983089983091983094983089983088983090983096983088

Case Report Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old Male A Case Reportand Literature Review

Adnan Bhatti1 Hindi Al-Hindi2 Ayman Azzam3 Tarek Amin1 and Ahmed Abu-Zaid4

983089 Department of Surgical Oncology King Faisal Specialist Hospital and Research Center (KFSHampRC) PO Box 983091983091983093983092Riyadh 983089983089983090983089983089 Saudi Arabia

983090

Department of Pathology and Laboratory Medicine King Faisal Specialist Hospital and Research Center (KFSHampRC) PO Box 983091983091983093983092Riyadh 983089983089983090983089983089 Saudi Arabia983091 Department of General Surgery Faculty of Medicine Alexandria University Alexandria 983090983089983093983090983094 Egypt 983092 College of Medicine Alfaisal University PO Box 983093983088983097983090983095 Riyadh 983089983089983093983091983091 Saudi Arabia

Correspondence should be addressed to Ahmed Abu-Zaid aabuzaidalaisaledu

Received 983089983090 April 983090983088983089983091 Accepted 983090 May 983090983088983089983091

Academic Editors E Itakura and B I Razzouk

Copyright copy 983090983088983089983091 Adnan Bhatti et al Tis is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited

Primary retroperitoneal teratomas involving adrenal glands are exceedingly uncommon accounting or only 983092 o all primary

teratomas Tey are more common in childhood and rarely occur in adults Only a very ew case reports have been documentedin literature so ar Herein we report a mature (benign) cystic retroperitoneal teratoma in the region o lef adrenal gland in a 983090983090-year-old otherwise healthy male patient who presented with a 983089-month history o lef 1047298ank pain In addition a literature review onteratomas is included

1 Introduction

Primary mature teratomas are uncommon nonsemino-matous germ cell tumors Tey are made up o well-differentiated parenchymal tissues thatare derived rom morethan one o the three germ cell layers (ectoderm mesodermand endoderm) [983089] Tey usually occur in midline (paraxial)structures Te most common sites are gonads (testes and

ovaries) ollowed by extragonadal sites such as intracranialcervical mediastinal retroperitoneal and sacrococcygealregions [983090] Primary retroperitoneal teratomas involvingadrenal glands are exceedingly uncommon accounting oronly 983092 o all primary teratomas [983090ndash983092] Tey are morecommon in childhood and rarely occur in adults [983093] Only a very ew case reports have been documented in litera-ture so ar [983094] Te majority o cases are asymptomaticpresent with nonspeci1047297c complaints or identi1047297ed inciden-tally on routine investigations [983095] Surgical excision o mature(benign) teratoma is required or a de1047297nitive diagnosis (by histopathological examination) [983096] and remains the mainstay o treatment [983097] Prognosis is ortunately excellent afer

complete surgical excision with an overall 1047297ve-year survivalrate o nearly 983089983088983088 [983089983088] Herein we report a mature (benign)cystic retroperitoneal teratoma in the region o lef adrenalgland in a 983090983090-year-old otherwise healthy male patient whopresented with a 983089-month history o lef 1047298ank pain

2 Case ReportA 983090983090-year-old otherwise healthy male patient presented toKing Faisal Specialist Hospital and Research Centre with a983089-month history o lef 1047298ank pain Physical examination wasremarkable or a palpable nontender and limitedly mobilemass on the lef 1047298ank All laboratory investigations wereunremarkable An abdominal contrast-enhanced computedtomography (C) scan showed a large lesion in the region o lef adrenal gland measuring 90 times 92 times 108 cm and demon-strating multiple cystic spaces with thin septations as well asmultiple areas o atty collections and coarse calci1047297cations(Figure 983089(a)) Te huge space-occupying lesion displacedthe lef kidney ineriorly (Figure 983089(b)) Bearing in mind



983090 Case Reports in Oncological Medicine

(a) (b)

F983145983143983157983154983141 983089 Abdominal contrast-enhanced computed tomography (C) scan (a) Cross-sectional (transverse) view showing a large lesion inthe regiono lef adrenal gland measuring 90times92times108 cm anddemonstrating multiple cystic spaces with thin septations as well as multipleareas o atty collections and coarse calci1047297cations (b) Coronal (rontal) view showing displacement o lef kidney ineriorly

a potential malignant tumor mass in the retroperitoneum(ie liposarcoma) the surgical oncology team advised or asurgical resection

Te patient underwent complete surgical resection o thelef adrenal mass Grossly the lef adrenal mass weighted983092983096983092g and measured 90 times 90 times 10 cm Te mass hadwell-circumscribed smooth borders and rubbery consis-tency Cut-section o the mass revealed multilocular cysticspaces whitish-gray walls scattered yellowish adipose tissuecollections mucus secretions and areas o calci1047297cations(Figure 983090(a)) Microscopically the walls were largely lined by respiratory columnar and squamous epithelium with variousproportions o mature well-differentiated parenchymal tis-sues derived rom the various three germ cell layers (Figures983090(b) and 983090(c)) No evidence o malignancy was identi1047297ed A

diagnosis o mature (benign) cystic retroperitoneal teratomainvolving the lef adrenal gland was made

Since there was no evidence o immature or malignantcomponents no radio- or chemotherapy was offered Tepatient was discharged uneventully in a stable condition Apostoperative 983094-month ollowup ailed to show any evidenceo tumor recurrence

3 Discussion

Germ cell tumors (GCs) can be broadly classi1047297ed intotwo main categories seminomatous and nonseminomatousGCs eratomas belong to nonseminomatous GCs and rep-

resent the most common orm o all GCs [983096] eratomas areencapsulated neoplasms composed o multiple parenchymaltissues (o varying degrees o differentiation) that are derivedrom more than one germ cell layer (ectoderm mesodermand endoderm) [983091]

Generally teratomas arise rom uncontrolled proliera-tion o pluripotent cells germ cells and embryonal cells Tetype o pluripotent cell greatly in1047298uences the presentationtime and involved location o teratoma eratomas o germcell sources can be congenital or acquired and are usually ound in gonads (testes and ovaries) In contrast teratomaso embryonic cell sources are always congenital and areusually ound in extragonadal locations such as intracranial

cervical retroperitoneal mediastinal and sacrococcygealsites [983090 983092]

According to the location o tumor teratomas can beclassi1047297ed into gonadal and extragonadal teratomas Gonadalteratomas are more common mostly primary neoplasmsmainly in adults and usually take place in gonads (testesand ovaries) [983095] Conversely extragonadal teratomas are lesscommon mostly secondary neoplasms mainly in inants andyoung children [983095] and usually take place in sacrococcygealmediastinal retroperitoneal and pineal gland sites (descend-ing order o requency) [983089983089ndash983089983091]

Furthermore according to the content o tumor ter-atomas can be classi1047297ed into solid cystic or mixed ter-atomas Solid teratomas lack organization and contain only parenchymal tissues Cystic teratomas contain only sacs o

1047298uid semi1047298uid or at whereas mixed teratomas contain bothsolid and cystic components [983092]

Besides according to the epithelial lining and dermalcontents o tumor teratomas can be classi1047297ed into epider-moid dermoid and teratoid teratomas (cysts) Epidermoidteratomas are lined by strati1047297ed squamous epithelium andlack dermal contents Dermoid teratomas are mostly lined by strati1047297ed squamous epithelium and contain various dermalcontents such as hair sweat and sebaceous glands eratoidteratomas are mostly lined by respiratory columnar epithe-lium and contain sebum [983092]

In addition according to the degree o tumor matura-tion teratomas can be classi1047297ed into mature and immature

teratomas Mature teratomas are generally benign asymp-tomatic and more common among emales Tey are highly

variable on histology and can be solid cystic or mixedTey contain different types o parenchymal tissues that arewell differentiated Mature cystic teratomas (AKA dermoidcysts) may have partially to completely well-developed organsystems On the contrary immature teratomas are histolog-ically solid teratomas and contain immature (undifferenti-atedundeveloped) parenchymal tissues and can be possibly benign possibly malignant or rankly malignant Tey aremore common among males [983096 983089983092]

Some mature (benign) and immature (possibly benign orpossibly malignant) teratomas have an increased tendency to



Case Reports in Oncological Medicine 983091

0 1 2 3 4 5 6 7 8 9 10

(cm)

(a)

L

(b)

C

F

(c)

F983145983143983157983154983141 983090 Mature (benign) cystic retroperitoneal teratoma in the region o lef adrenal gland (a) Grossly cut-section o the resected massrevealed multilocular cystic spaces whitish-gray walls scattered yellowish adipose tissues mucus secretions and areas o calci1047297cations (b)Hematoxylin amp Eosin (HampE stain) times983090983088 magni1047297cation a scanning magni1047297cation view o the lesion depicting its relationship with the adrenalcortex (open arrows) Te lumen [L] is lined by respiratory columnar epithelium (c) Hematoxylin amp Eosin (HampE stain) times983092983088 magni1047297cationa low magni1047297cation image o another cystic space lined by mucous-secreting epithelium (solid arrows) Te wall is ormed by cartilage tissues[C] at (adipose) tissues [F] and salivary gland tissues (open arrows)

become rankly malignant teratomas and rankly malignantteratomas have an increased propensity to metastasize Tisgroup o exceptionally rare teratomas is known as teratomas

with malignant transormation [983096] Te strati1047297ed squamousepithelial components o these teratomas are the ones atan increased risk o undergoing malignant transormationsIn addition teratomas with malignant transormation may produce components o somatic (non-germ cell) neoplasmssuch as carcinoma sarcoma and leukemia [983089983093 983089983094]

Occasionally a teratoma may contain various compo-nents o other germ cell tumor and hence it is not a pure ter-atoma per se but rather it is a mixed germ cell tumor and hasmalignant nature In inants and young children these com-ponents are requently endodermal sinus tumor and chorio-carcinoma A pure teratoma can be benign however highly aggressive in its clinical course as in a growing teratoma

syndrome (GS) GS reers to a rapidly growing puremature (benign) teratoma that appears during or ollowingchemotherapeutic eradication o malignant components o

a nonseminomatous germ cell tumor and it has normalserum tumor marker levels o alpha-etoprotein and humanchorionic gonadotropin [983089983095]

Te vast majority o retroperitoneal teratomas are sec-ondary neoplasms and mostly occur in males [983089983093] Primary retroperitoneal teratomas are extremely unusual neoplasmsaccounting or approximately 983089ndash983089983089 o all primary retroperi-toneal neoplasms and typically occur in neonates inantsand children age groups [983089983091] In adults these neoplasmscommonly present in the third or ourth decades o lives [983089983096]

Primary retroperitoneal teratomas involving adrenalglands are exceedingly uncommon accounting or only 983092o all primary teratomas [983090ndash983092] and can be mistaken or other




histologically related lipomatous adrenal neoplasms [983095]Tey are more common in childhood andrarely occur in adults [983093]

Only a ew case reports have been documented inliterature so ar [983094] Tey are more requently encountered atthe lef side [983091 983092] Te majority o cases are asymptomaticpresent with nonspeci1047297c complaints or identi1047297ed inciden-

tally on routine investigations [983095]eratomas can be diagnosed based on high index o clinical suspicion routine laboratory and radiographic inves-tigations [983089983096] With respect to high index o clinical sus-picion retroperitoneal teratomas involving adrenal glandsmay present congenitally or later in lie when they grow to massive sizes [983089983097] Clinical presentations are variable andinclude nonspeci1047297c abdominal1047298ankback pain obstructivegastrointestinal and genitourinary symptoms as well as lowerlimbgenital swelling due to lymphatic obstruction [983089983096] Tey can rarely present with complications such as secondary inections (abscess ormation) [983090983088] traumatic rupture lead-ing to acute peritonitis [983090983089] or malignant transormations[983090983090] Midline (paraxial) teratoma masses with restrictedmobility can be easily detected on physical examination [983090983091]

With respect to laboratory investigations retroperitonealteratomas can express a diversity o serum tumor markerssuch as elevated alpha-etoprotein (AFP) carcinoembryonicantigen (CEA) and CA 983089983097-983097 [983089983089ndash983089983091] Tese serum tumormarkers are helpul in clinical practice and can be used tomonitor successul treatment or detect relapse in patientswith speci1047297c tumor marker-secreting teratomas

With respect to radiographic investigations they play valuable roles in diagnosis o teratomas Plain radiographs(X-ray) can identiy calci1047297ed elements in 983094983090 o cases [983089983089ndash983089983091] whereas ultrasound (US) can greatly differentiate betweencystic and solid elements [983089983096] Computed tomography (C)scans can better distinguish between at (adipose tissue)and bone (calci1047297ed) masses [983090983092] On the contrary magneticresonance imaging (MRI) scans can offer better resolution o sof tissues easible identi1047297cation o benign and malignantneoplastic eatures and most importantly superior tumorstaging assessment [983090983093] However generally a de1047297nitive diag-nosis o teratoma demands a histopathological evaluation[983096]

Surgical excision o benign (mature) teratoma is requiredor a de1047297nitive diagnosis (by histopathological examination)[983096] and remains the mainstay o treatment [983097] Prognosis isortunately excellent afer complete surgical excision with anoverall 1047297ve-year survival rate o nearly 983089983088983088 [983089983088] eratomasare largely resistant to radio- and chemotherapy Adjuvant

radio- and chemotherapy are used only i malignant eatureso germ cell tumors are identi1047297ed on histopathological exam-ination [983089983097] A testicular ultrasound (US) is highly advisedto rule out potential coexisting germ cell tumors (GCs) asapproximately 983093983088 o men with retroperitoneal teratomashave testicular carcinomas in situ at the time o diagnosiswhich i lef untreated can develop into testicular germ celltumor [983090983094]

4 Conclusion

Primary retroperitoneal teratoma involving the region o adrenal gland is exceedingly rare (983092 o all primary

teratomas) and its occurrence in an adult is exceptionally uncommon However it should be regarded in the di-erential diagnosis in any patient presenting with a 1047298ank pain Histopathological examination o the resected tumorwarrants a de1047297nitive diagnosis Surgical excision o mature(benign) teratoma remains the mainstay o treatment with an

excellent 1047297ve-year survival rate o nearly 983089983088983088

Acknowledgment

Te authors sincerely acknowledge the editorial assistanceo Ms Ranim Chamseddin College o Medicine AlaisalUniversity Riyadh Saudi Arabia

References

[983089] D J B Ashley ldquoOrigin o teratomasrdquo Cancer vol 983091983090 no 983090 pp983091983097983088ndash983091983097983092 983089983097983095983091

[983090] S Bedri K Eranian S Schwaitzberg and A S ischlerldquoMature cystic teratoma involving adrenal glandrdquo EndocrinePathology vol 983089983091 no 983089 pp 983093983097ndash983094983092 983090983088983088983090

[983091] J L Polo P J Villarejo M Molina et al ldquoGiant maturecystic teratoma o the adrenal regionrdquo American Journal of Roentgenology vol 983089983096983091 no 983091 pp 983096983091983095ndash983096983091983096 983090983088983088983092

[983092] J L Groseld and D F Billmire ldquoeratomas in inancy andchildhoodrdquo Current Problems in Cancer vol 983097 no 983097 pp 983089ndash983093983091983089983097983096983093

[983093] M Goyal R Sharma P Sawhney M C Sharma and M BerryldquoTe unusual imaging appearance o primary retroperitonealteratoma report o a caserdquo Surgery oday vol 983090983095 no 983091 pp 983090983096983090ndash983090983096983092 983089983097983097983095

[983094] M Otani S sujimoto M Miura and Y NagashimaldquoIntrarenal mature cysticteratoma associated with renal dyspla-

sia case report and literature reviewrdquo Pathology International vol 983093983089 no 983095 pp 983093983094983088ndash983093983094983092 983090983088983088983089

[983095] J P K Hui W H Luk C W Siu and J C S Chan ldquoeratoma inthe region o an adrenal gland in a 983095983095-year-old manrdquo Journal of the Hong Kong College of Radiologists vol 983095 no 983092 pp 983090983088983094ndash983090983088983097983090983088983088983092

[983096] P Mathur M A Lopez-Viego and M Howell ldquoGiant primary retroperitoneal teratoma in an adult a case reportrdquo Case Reportsin Medicine vol 983090983088983089983088 Article ID 983094983093983088983092983090983092 983091 pages 983090983088983089983088

[983097] H Liu W Li W Yang and Y Qi ldquoGiant retroperitonealteratoma in an adultrdquo American Journal of Surgery vol 983089983097983091 no983094 pp 983095983091983094ndash983095983091983095 983090983088983088983095

[983089983088] C W Pinson S G ReMine W S Fletcher and J W BraaschldquoLong-term results with primary retroperitoneal tumorsrdquo

Archives of Surgery vol 983089983090983092 no 983089983088 pp 983089983089983094983096ndash983089983089983095983091 983089983097983096983097[983089983089] J K McKenney A Heerema-Mckenney and R V Rouse

ldquoExtragonadal germ cell tumors a review with emphasis onpathologic eatures clinical prognostic variables and differen-tial diagnostic considerationsrdquo Advances in Anatomic Pathology vol 983089983092 no 983090 pp 983094983097ndash983097983090 983090983088983088983095

[983089983090] Ueno Y O anaka M Nagata et al ldquoSpectrum o germ celltumors rom head to toerdquo Radiographics vol 983090983092 no 983090 pp 983091983096983095ndash983092983088983092 983090983088983088983092

[983089983091] H J Schmoll ldquoExtragonadal germ cell tumorsrdquo Annals of Oncology vol 983089983091 supplement 983092 pp 983090983094983093ndash983090983095983090 983090983088983088983090

[983089983092] F Gonzalez-Crussi Extragonadal eratomas Atlas of umor Pathology Second Series Fascicle 983089983096 Armed Forces Institute o Pathology Washington DC USA 983089983097983096983090




[983089983093] J Collen M Carmichael and Wroblewski ldquoMetastaticmalignant teratoma arising rom mediastinal nonseminoma-tous germ cell tumor a case reportrdquo Military Medicine vol 983089983095983091no 983092 pp 983092983088983094ndash983092983088983097 983090983088983088983096

[983089983094] D Harms S Zahn U Gobel and D Schneider ldquoPathology and molecular biology o teratomas in childhood and adoles-cencerdquo Klinische Padiatrie vol 983090983089983096 no 983094 pp 983090983097983094ndash983091983088983090 983090983088983088983094

[983089983095] C J Logothetis M L Samuels A rindade and D E JohnsonldquoTe growing teratoma syndromerdquo Cancer vol 983093983088 no 983096 pp983089983094983090983097ndash983089983094983091983093 983089983097983096983090

[983089983096] V Gupta H Garg A Lal K Vaiphei and S BenerjeeldquoRetroperitoneum a rare location o extragonadal germ celltumorrdquo Te Internet Journal of Surgery vol 983089983095 no 983090 article 983097983090983088983088983096

[983089983097] H G Gatcombe V Assikis D Kooby and P A S JohnstoneldquoPrimary retroperitoneal teratomas a review o the literaturerdquo Journal of Surgical Oncology vol 983096983094 no 983090 pp 983089983088983095ndash983089983089983091 983090983088983088983092

[983090983088] N alwar M Andley B Ravi and A Kumar ldquoSubhepaticabscess in pregnancymdashan unusual presentation o inectedprimary retroperitoneal teratomardquo Acta Obstetricia et Gyneco-

logica Scandinavica vol 983096983092 no 983089983089 pp 983089983089983090983095ndash983089983089983090983096 983090983088983088983093[983090983089] A Ferrero M Cespedes J M Cantarero A Arenas and

M Pamplona ldquoPeritonitis due to rupture o retroperitonealteratoma computed tomography diagnosisrdquo Gastrointestinal Radiology vol 983089983093 no 983091 pp 983090983093983089ndash983090983093983090 983089983097983097983088

[983090983090] P Y Chu H eng C C Lee and Y Y Chou ldquoAdenocarcino-mas arising rom primary retroperitoneal teratoma in an adultemale patientrdquo International Journal of Urology vol 983089983091 no 983089983088pp 983089983091983093983090ndash983089983091983093983092 983090983088983088983094

[983090983091] J C Huang J S Shin Y Huang et al ldquoPrimary retroperi-toneal teratoma in an adultrdquo Journal of the Chinese Medical Association vol 983094983094 no 983096 pp 983092983097983095ndash983093983088983088 983090983088983088983091

[983090983092] K aori J Rathod A Deshmukh et al ldquoPrimary extragonadalretroperitoneal teratoma in an adultrdquo Te British Journal of

Radiology vol 983095983097 no 983097983092983094 pp e983089983090983088ndashe983089983090983090 983090983088983088983094

[983090983093] M F Bellin J J Duron P Curet E Dion-Voirin and J GrelletldquoPrimary retroperitoneal teratoma in the adult correlation o MRI eatures with C and pathologyrdquo Magnetic ResonanceImaging vol 983097 no 983090 pp 983090983094983091ndash983090983094983094 983089983097983097983089

[983090983094] Gilligan and P Kantoff ldquoExtragonadal germ cell tumorsinvolving the mediastinum and retroperitoneumrdquo in UpoDatePatientPreview W K OhEd UptoDate Waltham MassUSA983090983088983088983097



Submit your manuscripts at

httpwwwhindawicom




(a) (b)

F983145983143983157983154983141 983089 Abdominal contrast-enhanced computed tomography (C) scan (a) Cross-sectional (transverse) view showing a large lesion inthe regiono lef adrenal gland measuring 90times92times108 cm anddemonstrating multiple cystic spaces with thin septations as well as multipleareas o atty collections and coarse calci1047297cations (b) Coronal (rontal) view showing displacement o lef kidney ineriorly

a potential malignant tumor mass in the retroperitoneum(ie liposarcoma) the surgical oncology team advised or asurgical resection

Te patient underwent complete surgical resection o thelef adrenal mass Grossly the lef adrenal mass weighted983092983096983092g and measured 90 times 90 times 10 cm Te mass hadwell-circumscribed smooth borders and rubbery consis-tency Cut-section o the mass revealed multilocular cysticspaces whitish-gray walls scattered yellowish adipose tissuecollections mucus secretions and areas o calci1047297cations(Figure 983090(a)) Microscopically the walls were largely lined by respiratory columnar and squamous epithelium with variousproportions o mature well-differentiated parenchymal tis-sues derived rom the various three germ cell layers (Figures983090(b) and 983090(c)) No evidence o malignancy was identi1047297ed A

diagnosis o mature (benign) cystic retroperitoneal teratomainvolving the lef adrenal gland was made

Since there was no evidence o immature or malignantcomponents no radio- or chemotherapy was offered Tepatient was discharged uneventully in a stable condition Apostoperative 983094-month ollowup ailed to show any evidenceo tumor recurrence

3 Discussion

Germ cell tumors (GCs) can be broadly classi1047297ed intotwo main categories seminomatous and nonseminomatousGCs eratomas belong to nonseminomatous GCs and rep-

resent the most common orm o all GCs [983096] eratomas areencapsulated neoplasms composed o multiple parenchymaltissues (o varying degrees o differentiation) that are derivedrom more than one germ cell layer (ectoderm mesodermand endoderm) [983091]

Generally teratomas arise rom uncontrolled proliera-tion o pluripotent cells germ cells and embryonal cells Tetype o pluripotent cell greatly in1047298uences the presentationtime and involved location o teratoma eratomas o germcell sources can be congenital or acquired and are usually ound in gonads (testes and ovaries) In contrast teratomaso embryonic cell sources are always congenital and areusually ound in extragonadal locations such as intracranial

cervical retroperitoneal mediastinal and sacrococcygealsites [983090 983092]

According to the location o tumor teratomas can beclassi1047297ed into gonadal and extragonadal teratomas Gonadalteratomas are more common mostly primary neoplasmsmainly in adults and usually take place in gonads (testesand ovaries) [983095] Conversely extragonadal teratomas are lesscommon mostly secondary neoplasms mainly in inants andyoung children [983095] and usually take place in sacrococcygealmediastinal retroperitoneal and pineal gland sites (descend-ing order o requency) [983089983089ndash983089983091]

Furthermore according to the content o tumor ter-atomas can be classi1047297ed into solid cystic or mixed ter-atomas Solid teratomas lack organization and contain only parenchymal tissues Cystic teratomas contain only sacs o

1047298uid semi1047298uid or at whereas mixed teratomas contain bothsolid and cystic components [983092]

Besides according to the epithelial lining and dermalcontents o tumor teratomas can be classi1047297ed into epider-moid dermoid and teratoid teratomas (cysts) Epidermoidteratomas are lined by strati1047297ed squamous epithelium andlack dermal contents Dermoid teratomas are mostly lined by strati1047297ed squamous epithelium and contain various dermalcontents such as hair sweat and sebaceous glands eratoidteratomas are mostly lined by respiratory columnar epithe-lium and contain sebum [983092]

In addition according to the degree o tumor matura-tion teratomas can be classi1047297ed into mature and immature

teratomas Mature teratomas are generally benign asymp-tomatic and more common among emales Tey are highly

variable on histology and can be solid cystic or mixedTey contain different types o parenchymal tissues that arewell differentiated Mature cystic teratomas (AKA dermoidcysts) may have partially to completely well-developed organsystems On the contrary immature teratomas are histolog-ically solid teratomas and contain immature (undifferenti-atedundeveloped) parenchymal tissues and can be possibly benign possibly malignant or rankly malignant Tey aremore common among males [983096 983089983092]

Some mature (benign) and immature (possibly benign orpossibly malignant) teratomas have an increased tendency to




0 1 2 3 4 5 6 7 8 9 10

(cm)

(a)

L

(b)

C

F

(c)



















4 Conclusion




Acknowledgment


References





































httpwwwhindawicom




0 1 2 3 4 5 6 7 8 9 10

(cm)

(a)

L

(b)

C

F

(c)



















4 Conclusion




Acknowledgment


References





































httpwwwhindawicom











4 Conclusion




Acknowledgment


References





































httpwwwhindawicom





















httpwwwhindawicom

Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old...

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