Immature Teratoma of the Palm: A Rare Site of Presentation

Abstract

Extragonadal teratomas in adults are an extremely rare entity. Teratomas may be mature or immature and are characterized by their midline presentation. We are presenting here a case report of immature teratoma of the palm in a 35-year-old female. The patient developed a recurrent swelling of the palm from which a wedge biopsy was taken and sent for histopathological examination. A diagnosis of “immature teratoma, grade 2” was made, whose margins were compromised. Later on ultrasonography (USG) abdomen and pelvis and whole-body magnetic resonance imaging (MRI) showed no significant findings ruling out the possibility of an occult primary. MRI palm showed a well-defined cystic lesion with loculations suggestive of teratoma. Re-exploration was advised to achieve free margins.

Primary, Nonmidline, Extragonadal, Immature Teratoma of the Palm with Axillary Nodal Metastasis: A Rare Case Report and Review of Literature

“…Coli et al 7 described an immature teratoma arising from the left posteroinferior thigh of an 86-year-old lady in the absence of clinical and radiological evidence of ovarian or any other tumor which was also managed by upfront surgical resection. Another case of immature teratoma in the palm similar to ours was described by Rajpoot et al, 8 where a diagnostic biopsy was done which revealed characteristic histopathological features and the patient was referred elsewhere with no follow-up details available. All reported presentations were in extremity with or without regional nodal involvement without the presence of an evident disease in the gonads.…”

“…Only seven cases have been reported in literature so far (►Table 1). [2][3][4][5][6][7][8] Few reported sites of extremity GCT are arm, 5 thigh, 6,7 humerus, 4 iliac bone, 3 and sole of the foot. 2 Various hypotheses have been proposed regarding their possible origin, but none have been conclusive.…”

Giant High-Grade Immature Teratoma of the Central Nervous System (CNS) in an Infant: A Case Report

“…Generally, teratomas are categorized into 2 subtypes: mature and immature. Mature teratomas are considered benign tumors that can be cystic or solid, consisting of well-differentiated adult tissues from one or more germ cell layers [ 8 , 9 ]. Immature teratomas, on the other hand, are malignant tumors.…”

“…Mature teratomas are reportedly more common than immature ones and immature congenital teratomas are considered extremely rare lesions. [ 5 , 8 , 10 ]. However, our case deviated from the norms mentioned earlier, as it occurred in the left hemisphere of the brain, involving temporal, parietal, and occipital brain lobes, and was far from the midline.…”

“…These neoplastic lesions differ from mature cystic teratomas in that they demonstrate clinically malignant manners, are much scarcer, and affect younger people more than older people [ 5 ]. Moreover, they are further classified into 3 grades based on World Health Organization (WHO) 2014 recommendations, which is a 3-degree grading system including “low grade” (grade I) immature teratomas and “high-grade” (grade II and III) ones [ 6 – 8 ]. Although congenital intracranial immature teratomas are extremely rare lesions, they can sometimes grow to sizes big enough cause death and thus require immediate medical attention [ 2 , 5 ].…”