Adrenal Teratoma: a Case Series and Review of the Literature

Abstract

Adrenal teratomas are rare neoplasms and there is limited data on their surgical outcomes and long-term prognosis. We aimed to review our institutional experience and compare this to the existing literature on adrenal teratomas in adults and children. An institutional pathology database was searched for cases of adrenal teratoma (June 1956-July 2016). Clinical and imaging data were abstracted from the medical records and pathology slides were obtained for review. In addition, a PubMed search for "adrenal teratoma" from June 1952 to July 2016 was performed to identify reports of primary adrenal teratoma in patients of all ages. Of 7706 patients who underwent adrenalectomy during the study period at our institution, three patients were identified with adrenal teratoma. Patients were 24, 26, and 29 years of age, respectively. Two patients presented with abdominal pain and two of the three underwent a laparoscopic adrenalectomy. A pathologic examination revealed mature cystic teratomas that frequently displayed well-differentiated respiratory, digestive, and squamous epithelia. Eighteen case reports in the literature were identified in patients 17-61 years of age. Patients presented most frequently with abdominal or flank pain (63.6%). Median tumor diameter was 9.0 cm and tumors were frequently left-sided (81.8%), cystic (63.6%), and calcified (72.7%) on either radiologic or pathologic examination. Primary adrenal teratomas are rare neoplasms that typically present as large, left-sided nodules with cystic and calcified components seen radiographically. Although the data are limited, they are generally amenable to laparoscopic resection and have a very favorable prognosis.

Primary adrenal teratoma: A case series and review of the literature

“…Pediatric adrenal teratomas are uncommon, repre-senting~5% of all pediatric teratomas (12). Although pediatric cases of adrenal teratomas have not been found in our literature review, primary adrenal teratomas have been reported in neonates, infants and children.…”

Giant retroperitoneal teratoma displacing kidney causing acquired crossed non-fused renal ectopia: rare case report

“…Till now the maximum size reported in literature is of mature cystic teratoma in a 33 yr old lady, extending from pancreas upto pelvis about 35x35cm size (weight not mentioned) and of 22x17x7cm size and 1.6kg weight, in a 39 yr old lady, at rt adrenal region. 5,8 Considering volume-33,750cm 3 , weight 12kg vs age of patient the case is probably largest ever reported in a child as young as 15 yrs of age. There was 10kg fluid and 2kg solid mass in tumor ( Figure 5).…”

“…There are report of adrenal origin of mature teratoma. 3,4 Most of benign teratomas are asymptomatic and attain enormous size before presentation.…”

“…This is a rarest of rare case of giant retroperitoneal teratoma in a 15 yr old female child, causing displacement of left kidney to right by its huge volume (45X30X25cm=33750cm 3 ), making it appear like 'acquired crossed nonfused renal ectopia'. Tumor resected 5 yrs back and patient is free of any symptoms or recurrence in 5 yrs of follow up.…”

“…3 Laparoscopic excision is possible in teratoma esp if mature teratoma is suspected. There are reports of laparoscopic /retroperitoneoscopic resection of adrenal teratoma.…”