scholarly journals Retroperitoneal Teratoma in an Adult: A Potential Pitfall in the Differential Diagnosis of Adrenal Myelolipoma

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Madoka Kataoka ◽  
Hiroshi Fukushima ◽  
Yasukazu Nakanishi ◽  
Minato Yokoyama ◽  
Nobuaki Funata ◽  
...  

We report a 32-year-old female case of a right adrenal gland mass detected on CT scan at medical checkup. CT and MRI showed a mass of 5.1 cm made of fat and calcification in the right adrenal gland, leading to the clinical diagnosis of adrenal myelolipoma. Because of its relatively large size and the patient’s desire, the patient underwent gasless single-port retroperitoneoscopic adrenalectomy using the RoboSurgeon system. Histopathological examination revealed that the cystic tumor is composed of keratinized epidermis, mature fat, nerve, cartilage, bone, and sebaceous glands compressing the normal adrenal gland, leading to the diagnosis of retroperitoneal mature cystic teratoma. The patient remains free of recurrence 29 months after surgery. Retroperitoneal teratoma is relatively rare but clinically important because of high possibility of malignancy. In a case of an adrenal mass difficult to clinically distinguish retroperitoneal teratoma from adrenal myelolipoma, surgical resection via a minimally invasive approach would be the best therapeutic option.

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
André Tojal ◽  
Natália Santos ◽  
João Vicente ◽  
Noel Carrilho ◽  
Carlos Casimiro

Abstract Primary retroperitoneal teratomas involving adrenal glands are extremely uncommon, particularly in elderly males. Only a few case reports have been documented in the literature so far. We report a mature cystic retroperitoneal teratoma in the region of left adrenal gland in an asymptomatic 75-year-old male patient. It was incidentally found on an abdominal computed tomography scan and was thought to be an adrenal adenoma. Because of its relatively large size and the patient’s request, he underwent a laparoscopic left adrenalectomy. Histopathological examination revealed a benign mature cystic retroperitoneal teratoma in the region of the left adrenal gland. The patient had an uneventful postoperative course and is free of recurrence after 20 months of follow-up. Considering the diagnostic difficulty of retroperitoneal teratoma by radiologic imaging, and its risk of malignancy, surgical resection via a minimally invasive approach would be the best diagnostic and therapeutic option. A literature review on teratomas is included.


2015 ◽  
Vol 5 (2) ◽  
pp. 46-49
Author(s):  
G Pandey ◽  
B Thakur ◽  
M Devkota

Adrenal myelolipoma is a benign uncommon tumor of adrenal gland which is mostly diagnosed incidentally. Huge adrenal myelolipoma are very rare. Histopathological examination gives the confirmed diagnosis. Here we present a 76 years old female with huge retroperitoneal mass, diagnosed as adrenal myelolipoma on the basis of histopathological examinations. Surgical management is the treatment of choice for large symptomatic tumors.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 728
Author(s):  
Jeong-Hyouk Choi ◽  
Koo-Han Yoo ◽  
Dong-Gi Lee ◽  
Gyeong-Eun Min ◽  
Gou-Young Kim ◽  
...  

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Hiroharu Kobayashi ◽  
Shinichi Shibuya ◽  
Kentaro Iga ◽  
Keiichiro Kato ◽  
Airi Kato ◽  
...  

A 30-year-old woman (gravida 0) visited our hospital with a complaint of right lower abdominal pain. Transvaginal ultrasonography revealed a 5-cm swollen right ovary, which was suspected to be a mature cystic teratoma. Pelvic examination revealed moderate pain. Contrast-enhanced computed tomography showed a 44-mm cystic mass containing fat and calcified material in the right pelvis. Since torsion was suspected, emergent laparoscopic surgery was performed. Intraoperative findings were a swollen right ovary without torsion or congestion. Two small pedunculated 1- and 2-cm diameter paratubal cysts that grew from almost the same place of the ampulla of the right fallopian tube were observed. The thin stalk of the 1-cm paratubal cyst was entangled around the stalk of the 2-cm paratubal cyst, with its head congested. Through a small abdominal laparoscopic incision, the tumor of the right ovary and the two paratubal cysts were excised. Histopathological examination revealed that the right ovarian tumor was a mature cystic teratoma, and the two paratubal cysts had no malignancy. This case showed that only a 2-cm tumor with congestion caused the acute abdomen.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hiroshige Murata ◽  
Yasushi Miyauchi ◽  
Takashi Nitta ◽  
Kenta Takahashi ◽  
Ippei Tsuboi ◽  
...  

Introduction: Ventricular tachycardia (VT) associated with a primary cardiac tumor is extremely rare. Complete resection of a tumor was reported to be effective in a treatment of this VT. However, the mechanism of the cardiac tumor-related VT (CT-VT) is still unknown, and the therapeutic strategy of the VT in patients with unresectable tumor is not determined. Methods and Results: Four patients (20 ± 15 years, 3 males) with CT-VT (fibroma in 2, lipoma in 1, and hemangioma in 1 patient) were investigated. All four patients developed repetitive forms of monomorphic VTs, which were reproducibly induced by programmed ventricular stimulation and terminated by burst pacing. These VTs exhibited a right bundle branch block QRS morphology (QRS duration, 160 ± 28 ms) with a pseudo-delta wave (75 ± 10 ms) at a cycle length of 330 ± 86 ms. Intraoperative electroanatomical mapping showed a radially spreading activation pattern originating from the epicardial border of the tumor, where fractionated and late potentials were detected during sinus rhythm. Histopathological studies of the sections from this border area revealed tumor infiltration to the surrounding myocardium and myocardial cell disorganization exhibiting myocardial disarray. In 2 patients in whom the cardiac tumor was completely resected, cryoablation was added to the resection line. In the remaining 2 patients in whom complete resection of the tumor was unfeasible, encircling cryoablation to entirely isolate the unresectable tumor was effective in suppressing their VTs. Conclusions: The mechanism of CT-VT is reentry localized at the epicardial border of the tumor. Myocardial disarray associated with infiltration of the cardiac tumor may be a substrate of this VT. Encircling cryoablation along the border of the tumor may be a therapeutic option for an unresectable CT-VT.


1998 ◽  
Vol 84 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Armando Rossi ◽  
Roberto Incensati

This paper describes a case of adrenal myelolipoma with an unusual characteristic: the presence of bone spicules. The lesion was associated with an accessory adrenal gland containing foci of myeloadiposis. The authors believe that myelolipoma and myeloadiposis are closely associated and are in fact the expression of a single process that is both focal (myeloadiposis) and diffuse (myelolipoma). The process consists of the differentiation of choristomatous primitive mesenchymal cells into hematopoietic tissue, adipose tissue and, in rare cases, bone tissue.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
E. M. Der ◽  
S. Seidu

Background. Preoperative diagnosis of immature cystic teratoma can be challenging for clinicians. In this report, we present three cases.Methods. We describe three women aged 10, 20, and 23 years, respectively, who presented with abdominal masses which were diagnosed by abdominal ultrasound as mature cystic teratomas. All women had emergency laparotomy and oophorectomy.Results. Histopathological examination reported these ovarian tumours to be immature cystic teratomas. This case report also provided a brief summary of the clinicopathological features of all ovarian teratomas diagnosed in two centres during the period of review.Conclusion. Immature ovarian teratoma affects primarily younger patients; it is important for clinicians to have a high sense of suspicion whenever the diagnosis of a germ cell tumour is entertained.


2018 ◽  
Vol 12 (2) ◽  
pp. 16-20
Author(s):  
Gehanath Baral ◽  
Rijuta Joshi

Aims: The purpose of this study is to review the reintroduced minimally invasive surgical practice in the hospital after a couple of decades long gap. Methods: It is a two years (2015 to 2017) retrospective cross-sectional study carried out in Paropakar Maternity and Women’s Hospital. The patients with pre-operative diagnosis of benign condition underwent laparoscopic surgery; hysteroscopy was diagnostic and operative both. Data were collected by demographics, indication of surgery, nature of surgery, complications, hospital stay and histo-pathological reports. Data were entered in the SPSS and MS-excel. Results were presented as tables and graphs.Results: Sixty five and 39 women underwent laparoscopic surgery and hysteroscopy respectively. None of them had major complications and hospital stay was1-3 days in majority.  The most common age group was 31-35 years. Preoperative diagnoses of them were adnexal tumor in 47 women, fibroid uterus in six, AUB in two, ectopic pregnancies in four, PCOD in two and one women each with primary sub-fertility and POP Q II with elongated cervix. Laparoscopic cystectomy was performed on 25 women for the adnexal masses while 13 women underwent laparoscopic oophorectomy for the ovarian masses. Total laparoscopic hysterectomy was the second commonest surgery (n=12). On histopathological examination of the ovarian tissues, mature cystic teratoma was the commonest finding (n=18) followed by the endometriotic cysts (n=9), benign serous cystadenoma (n=7) and mucinous cystadenoma (n=4).  Conclusions: Laparoscopy and hysteroscopy procedures have become the alternative in surgical modality at this hospital.


2016 ◽  
Author(s):  
Nikita Kumari ◽  
Reenu Kanwar ◽  
Bindu Bajaj ◽  
Garima Kapoor

Introduction: Ovarian fibrothecomas represent an ovarian stromal neoplasm developing in a wide spectrum of clinical settings. These tumors have been described as rare ovarian neoplasm, accounting for about 4% of all ovarian tumors. We report a case whose clinical presentation was highly deceptive and was clinically and radiologically diagnosed as malignant ovarian tumor. Ascitic fluid cytology revealed absence of malignant cells. On histopathological examination, it was diagnosed as benign fibrothecoma with cystic changes. Postoperative follow-up for about six months was uneventful. Case: A 45 year old female presented to the gynae emergency with large abdominal lump of 20 weeks size with acute pain abdomen. She was admitted for initial management and thorough evaluation. Hematological and biochemical parameters were within normal limits. USG revealed a large multilocular, predominantly cystic lesion 20.9x9.6x11.4 cm in pelvis. CECT revealed ovarian cystadencarcinoma left ovary with locoregional mass effect, mild ascites and suspicious metastasis to internal iliac lymph nodes. Radiological and preoperative clinical diagnosis was malignant ovarian tumor. Panhysterectomy and omentectomy was performed. On gross examination, a well encapsulated, multinodular cystic tumor of left ovary about 17x14x7 cm was identified. Cut surface was mostly solid with few cystic areas. Uterus, cervix, right ovary and both tubes were unremarkable. On microscopic examination, multiple sections showed spindle shaped cells in storiform and palisading pattern. No mitotic activity was identified. On special staining, it was positive for vimentin, which is a characteristic feature of ovarian fibrothecoma. Conclusion: The accurate preoperative diagnosis of ovarian fibrothecoma with cystic changes could have prevented the extensive surgical intervention such as bilateral salpingo- oopherectomy with hysterectomy.


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