Retroperitoneal dermoid cyst mimicking a liposarcoma based on imaging assessment: case report and literature review

Abstract

Dermoid cyst is a kind of mature cystic teratoma that contains only one germ layer. It usually occurs in the head and neck, retroperitoneal dermoid cysts are uncommon. Teratomas are characterized by mixed density and features like calcification or air-fluid level. Here, we present a case of 40-year-old female with a 12.1 cm × 10.0 cm retroperitoneal fatty mass which showed no calcification and few other specific characteristics of teratoma. Thin and uniform separations were observed. On PET-CT, it was adherent to several retroperitoneal organs like left adrenal gland and left kidney, and had a close relationship with several retroperitoneal vessels like aorta, superior mesenteric arteriovenous, left superior renal artery and inferior vena cava. On PET-CT, mild 18F-FDG uptake was observed. Based on the above imaging findings, a clinical diagnosis of liposarcoma was considered. After laparotomy and open surgery transit through a left vertical incision, the histopathologic examination revealed a retroperitoneal dermoid cyst. During a 2-month followup, the patient recovered well without discomfort and recurrence. Comparison between dermoid cyst and liposarcoma in imaging findings was performed. In dermoid cysts, there can be thin and uniform separations, rather than linear, localized and irregular high density in liposarcoma. The difference between dermoid cyst and mature cystic teratoma is yet to be clarified. A review of clinical and histopathological features of retroperitoneal dermoid cyst was also performed to enhance the level of the diagnosis and management.

Retroperitoneal dermoid cyst complicated with uterine adenomyoma: a case report and literature review

“…Retroperitoneal dermoid cysts are often asymptomatic if they do not exert pressure on surrounding organs, and may thus only be detected incidentally during routine medical examinations or even at autopsy. 9 – 10 Alternatively, patients may have abdominal symptoms, including abdominal pain, distension, and discomfort, typically intermittent and exacerbated following activity or meals, with symptom severity correlated with cyst size and location. 11 Some patients may exhibit mild symptoms of peritoneal irritation, such as tenderness or rebound pain, following cyst rupture, due to stimulation of the surrounding tissues by the contents of the cyst.…”

Alpha-fetoprotein-elevated postpubertal testicular teratoma with retroperitoneal metastasis on 18F-FDG PET/CT: case report and literature review

“…Most patients with retroperitoneal teratoma are asymptomatic, and the most common symptom is nonspecific pain. Patients whose adrenals were compressed may present with vertigo and hypertension ( 15 ). In our case, the patient’s testicular teratoma caused pain, while the retroperitoneal teratoma did not cause any symptoms, which was consistent with previous studies.…”

“…A literature search was performed on the PubMed and database from 1997 to 2022, using the keyword “retroperitoneal teratoma” and “PET/CT.” There were night cases of retroperitoneal teratoma with PET/CT findings. The basic information and metabolism of retroperitoneal teratoma are summarized in Table 1 ( 15 , 24–29 ). Out of these night cases, only one patient was 7 months old, while other patients were adults, ranging in age from 23 to 49 years, with more males than females.…”

Marsupialization of a Floor-of-Mouth Dermoid Cyst to Temporize Airway Distress

“…Dermoid cysts are uncommon congenital formations that can occur in diverse regions of the human body such as the head, neck, retroperitoneum, ovaries, and brain [5][6][7][8][9]. These cysts commonly present in the head and neck region; most of which, however, are diagnosed before the age of five years old [5].…”