ABSTRACT
Teratomas are congenital tumors comprising of tissues arising from pluripotent embryonic cells. Their common sites of occurrences are ovary, testis, mediastinum and retroperitoneum. Retroperitoneal teratomas are extremely rare in adults but occur in 3% of children. The presence of a cystic or complex adnexal mass during pregnancy is common with mature teratoma reported in approximately 30-50% of pregnancies. The ultrasound is the number one method of detection. The use of tumor markers is limited because it alters its value during pregnancy. We report a case of a 18 year old female patient who came to the General Hospital Dr. Miguel Silva in Morelia, Michoacán with a gestation age of 10.2 weeks and a recent diagnosis of an asymptomatic adnexal mass. Using the transvaginal approach, the ultrasound reported an irregular gestational sac with the absence of cardiac activity in the embryo. A diffusely echogenic adnexal mass with oval appearance, wall regularity and homogeneous internal echos of 12.96x8.99cm. Exploratory laparotomy was performed finding normal uterus and ovaries, with the posterior retroperitoneal resection of the 15cm multi-lobed tumor. The surgical specimen measured 13x12x8cm, had a brownish color, wall irregularity, soft consistency, multi-lobed, and a yellowish interior greasy material. Microscopically the tumor is delimited with a firm capsule composed of a hyaline-fibrous tissue, lined by squamous keratinized epithelium, with multiple layers of keratin. This anato-pathologic finding is diagnostic of retroperitoneum mature teratoma.
Key words: Retroperitoneal Pelvic Teratoma.
RÉSUMÉ
Se rapporte le cas d'une patiente de 18 ans, avec 10,6 semaines de grossesse et une tumeur annexielle gauche de diagnostic récent, asymptomatique, avec rapports d'échographie transvaginale avec un sac gestationnel de contour irrégulier, avec embryon sans rythme cardiaque fœtal. Apprécié un aperçu image ovoïdes, régulière, bien définie, avec des échos très bien à l'intérieur de 12.96 x 8,99 cm. puisque la laparotomie exploratoire a montré à l'utérus et les pièces jointes normales, il a été décidé l'approche retroperitoneal et un 15 cm, multilobulate tumeur a été trouvée. Le spécimen chirurgical mesurée 13 x 12 x 8 cm, cohérence de mou, brun pâle, irrégulier, multilobulada, forme avec le matériel jaune pâle sortie. Au microscope, les murs étaient composées de tissu fibreux, hialinizado, recouvert par un épithélium pavimenteux kératinisant, sans les annexes, de qui dégageait plusieurs feuilles de kératine. Ces constatations anatomiques pathologiques ont été considérés comme le diagnostic de tératome de localisation rétropéritonéale.
Mots clés: Tératome rétropéritonéale pelvienne
RESUMO
Relatamos o caso de um paciente de 18 anos com 10,6 semanas de gravidez e tumor anexial esquerda recém-diagnosticados assintomáticos com o relatório ultra-som endovaginal com saco gestacional irregular com embrião sem frequência cardíaca fetal. Uma imagem apreciado oval, contorno regular é bem definida, com ecos finas dentro de 12,96 x 8,99 centímetros. Desde laparotomia exploratória mostrou o útero normal e anexos, foi decidida a abordagem retroperitoneal e encontraram um tumor de 15 cm, multilobulado. A peça cirúrgica medida 13 x 12 x 8 cm, marrom claro, consistência macia, irregularmente lobadas, com saída de material amarelo claro. Paredes microscopicamente observados compostas por tecido fibroso hialinizado queratinizante epitélio escamoso coberto, sem anexos, em que várias folhas saiu queratina. Estes achados patológicos foram considerados diagnóstico teratoma maduro retroperitoneal.
Palavras-chave: Teratoma pelvico retroperitoneal
