Work-ups/Operative Findings 2 (Teratoma)

Figure tuab_21a_n.jpg: Abdomen x-ray in a 2-month-old boy. There is a huge mass which occupies nearly the whole peritoneal cavity. On the left side near the abdominal wall and in the lower abdomen the displaced colon is recognizable. Figure tuab_21b_n.jpg: CT: Homogeneous mass at the level of the liver (left side) and of the stomach (right side) which occupies half of the belly (square). The liver is displaced to the left side. Figure tuab_21c_n.jpg: During surgery a dissolving mass without a visible capsule was seen which contained hemorrhages and cysts. tuab_21d_n.jpg: CT 2 months following surgery: There is an inhomogeneous mass at the level of the kidneys without distinct limits (ring). tuab_21e_n.jpg: During reoperation black-blue masses with cystic parts at the upper tumor pole which lie beside and behind the colon become visible. tuab_21a_n.jpg to tuab_21e_n.jpg: Due to the operative findings during the first operation and the local recurrence already two months later the diagnosis is a retroperitoneal malignant tumor which could not have been removed completely during the first intervention. tuab_21a_n.jpg (if not a nonrotation of the intestine was present), tuab_21b_n.jpg, tuab_21d_n.jpg and tuab_21e_n.jpg support a retroperitoneal localization. The histological diagnosis was an immature non-differentiated teratoma of the retroperitoneum. A part of the tumor left behind during the first operation had some maturation in the meantime; on the other hand, the malignant part remained uninfluenced. Although it is a midline tumor, teratoma may demostrate an asymmetrical right-left size.