Primary retroperitoneal mature cystic teratoma (dermoid cyst) in a 51-year-old male:Case report and historical literature review

Abstract

Objectives:Primary retroperitoneal mature cystic teratomas are exceedingly uncommon in males aged 50 years and above, and only seven cases have been reported in the literature so far. They usually occur in infants less than 6 months and young females. The aim of this article is to present a rare case of a 51-year-old male with a primary retroperitoneal mature cystic teratoma located in the right infrarenal area adherent to the psoas muscle and to discuss a historical literature review.Methods:An incidental hypoechoic, solid appearing 8.2 × 7.6 × 7.8 cm3 mass arising off the inferior pole of the right kidney was found on abdominal ultrasound during evaluation for a history of alcoholism. Computerized tomography (CT) scan revealed small calcifications in the lower part of the cystic mass. Laparotomy with excision of the retroperitoneal mass was performed.Results:On gross examination, the specimen consisted of a cyst filled with pale yellow greasy material with entrapped hair. Histopathologic examination revealed a dermoid cyst with focal chronic inflammation, dystrophic calcification, and foreign-body giant cell reaction.Conclusions:Retroperitoneal mature cystic teratoma in an older male is extremely rare. Primary gonadal teratoma with retroperitoneal metastasis should be excluded first. Evaluation of age and location of tumor are critical for its prognosis. Complete excision of tumor is necessary to evaluate whether there are immature and solid elements which need long-term follow up due to the increased risk of malignancy.

Primary Mature Cystic Teratoma Compressing the Prostate in a 28-Year-Old Male: A Case Report and Literature Review

“…Computed tomography scans and MRI are more appropriate. MRI can visualize the degree of invasion of adjacent structures as well as tumor content and may indicate if a wider resection is required [20, 21].…”

Huge Retroperitoneal Dermoid: A Presentation

“…Malignant tumors account for around 80% of retroperitoneal tumors and include liposarcoma, leiomyosarcoma (50%), lymphoma (commonly non-Hodgkin lymphoma), malignant tumors from specific organs, germ cell tumors, chordomas, and Retroperitoneal Lymph Node (RPLN) secondaries with hard nodules. 3 Cystic masses can be classified as neoplastic and non-neoplastic. Neoplastic cystic masses include mature teratomas, mucinous cystadenomas, and cystic mesotheliomas.…”

“…Retroperitoneal masses with calcification include paraganglioma, ganglioneuroma, malignant fibrous histiocytoma, and dedifferentiated liposarcoma. 3…”

“…8 Teratomas can, therefore, be further classified according to the number of layers present (monodermal, bidermal, and tridermal), according to the epithelial lining (epidermoid, dermoid and teratoid), according to the degree of differentiation (mature and immature), according to content (solid, cystic or mixed), and according to presence of malignancy (present or not). 3…”

Practical approach to primary retroperitoneal masses in adults

“…When they do not originate from organs such as the kidneys, adrenal glands, pancreas, or bowel loops, retroperitoneal masses are classified as primary and are categorized as solid or cystic (Table 1), depending on their appearance on imaging ( 5 , 6 ) . Solid lesions can be divided into four groups, by origin ( 3 ) : mesenchymal, neural, germ-cell, and lymphoproliferative.…”