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 Table of Contents  
CASE REPORT
Year : 2017  |  Volume : 3  |  Issue : 2  |  Page : 57-58

A Case Report of Retroperitoneal Dermoid


1 Assistant Professor, Department of GI Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar, India
2 Associate Professor, Department of GI Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar, India
3 Professor, Department of GI Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar, India

Date of Web Publication11-Dec-2020

Correspondence Address:
Utpal Anand
Associate Professor, Department of GI Surgery, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna-14, Bihar
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 


Primary dermoid of retroperitoneal space is exceedingly uncommon. Primary dermoid, mainly occurs in gonads (testes and ovaries), mostly in adults. Extragonadal dermoids are less common, mainly occur in infants and young children. We report a case of mature retroperitoneal dermoid in left upper quadrant retroperitoneal space in a 15 year old boy.

Keywords: Abdominal lump, Dermoid , Extragonadal dermoid, Retroperitoneal space


How to cite this article:
Kumar S, Anand U, Raj AK, Singh RK, Mandal M. A Case Report of Retroperitoneal Dermoid. J Indira Gandhi Inst Med Sci 2017;3:57-8

How to cite this URL:
Kumar S, Anand U, Raj AK, Singh RK, Mandal M. A Case Report of Retroperitoneal Dermoid. J Indira Gandhi Inst Med Sci [serial online] 2017 [cited 2021 Dec 7];3:57-8. Available from: http://www.jigims.co.in/text.asp?2017/3/2/57/303152




  Introduction Top


Primary mature dermoidare uncommon, nonseminomatous germ cell tumor[1]. They are made up of well differentiated parenchymal tissues that are derived from more than one of the three germ cell layers (ectoderm, mesoderm and endoderm). They usually occur in mid line structures. The most common sites are gonads (testes and ovaries) followed by exragonadal sites such as intracranial, cervical, mediastinal, retroperitoneal and sacrococcygeal. They are more common in childhood and rarely occur in adults. The majority of cases are asymptomatic, present with non specific symptoms. Surgical resection is the mainstay of treatment and it is also required for definitive diagnosis. Prognosis is excellent after complete surgical excision. Here , we report a case of mature dermoid of left upper retroperitoneal space, which presented as abdominal lump.


  Case Report Top


A 15 years old otherwise healthy boy came to OPD, department of G. I. Surgery, IGIMS, PATNA with 3 month history of slow growing abdominal lump in left upper abdomen from left hypochondrium upto umbilicus. Physical examination revealed a cystic, nontender, fixed lump. All laboratory investigations were unremarkable.



Patient underwent surgical resection of retroperitoneal mass. Mass was encapsulated, densely adhered to pancreas, infiltrated and bulged into tranverse mesocolon, close to the left kidney. Cut section revealed some dirty coloured fluid, large amount of cheesy material, bunches of hair, solid mass about 12x8x7 cms with multiple teeth, bones and soft tissues covered with skin like Structure.



The patient was discharged uneventfully in a stable condition on 6th postoperative day.


  Discussion Top


Germ cell tumor can be broadly classified into two main categories - seminomatous and non seminomtous. Teratoma belongs to non seminomatous group. Generally teratoma arises from uncontrolled proliferation of pluripotent cell germ cell and embryonal cell[1],[2],[3]. The type of pluripotent cell determines the presentation and location of teratomas. Teratomas of germ cells can be congenital or acquired and are usually found in gonads (testes and ovaries). In contrast, teratomas of embryonal cells are always congenital and are usually found in extra gonadal sites such as intracranial cervical retroperitoneal mediastinal and sacroccygeal sites[4].

According to location of tumor, Teratoma can be gonadal and extragonadal. Gonadal teratomas are more common and mostly primary occur mainly in adult[5]. Extra gonadal teratoma are less common. Secondary, mainly occurs in infants and young children and usually take place in sacrococcygeal, mediastinal , retroperitoneal and pineal gland sites (descending frequency).

According to content; Teratomas can be classified into solid, cystic and mixed.

According to epithelial lining and dermal contents of tumor; Teratomas can be classified as epidermoid, dermoid and teratoid.

Vast majority of retroperitoneal dermoid are secondary neoplasm and mostly occurs in males. Primary retroperitoneal dermoids are extremely unusual accounting for approximately 1 -11% of all primary retroperitoneal neoplasm and typically occur in neonates, infant and children age group[5].


  Conclusion Top


Primary retroperitoneal teratoma involving the region of adrenal gland is exceedingly rare (4% of all primary teratomas), and its occurrence in an adult is exceptiona uncommon. However, it should be considered in the differential diagnosis in any patient presenting with a flank pain. Histopathological examination of the resected tumor confirmed a definitive diagnosis. Surgical excision of mature (benign) teratoma remains the mainstay of treatment with an excellent five-year survival rate of nearly 100 percent.



 
  References Top

1.
Goyal M, Sharma R, Sawhney P, Sharma M. C, and Berry M. “The unusual imaging appearance of primary retroperitoneal teratoma: report of a case,” Surgery Today, 1997; 282-4.  Back to cited text no. 1
    
2.
Mathur P, Lopez-Viego M. A, and Howell M, “Giant primary retroperitoneal teratoma in an adult: a case report,” Case Reports in Medicine, vol. 2010, Article ID 650424, 3 pages.  Back to cited text no. 2
    
3.
Liu H, Li W, Yang W, and Qi Y, “Giant retroperitoneal teratoma in an adult,” American Journal of Surgery; 2007; no. 6, pp. 736-7.  Back to cited text no. 3
    
4.
Schmoll H. J, “Extragonadal germ cell tumors,” Annals of Oncology; 2002; vol. 13, supplement 4, 265-72.  Back to cited text no. 4
    
5.
Taori K, Rathod J, Deshmukh A et al., “Primary extragonadal retroperitoneal teratoma in an adult,”The British Journal of Radiology;2006; vol. 79, no. 946, e120-e122  Back to cited text no. 5
    




 

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