Massive primary retroperitoneal immature teratoma in an adult: A case report

INTRODUCTION AND IMPORTANCE: Teratoma is a rare clinical entity in adults and commonly arises from gonads. Being rare, retroperitoneal teratomas account for 4 % of all primary teratomas. A teratoma can be mature or immature, of which mature is more common in adults and immature is more common in neonates or children. It is labeled immature if at least one from the three germ layers lacks differentiation. To the best of our knowledge, this is the first case of primary retroperitoneal ‘immature’ teratoma in a male adult. CASE DESCRIPTION: A 53-year-old male, following a road traffic accident, was investigated for the same and was incidentally detected with a retroperitoneal mass based on Chest X-ray, USG abdomen, and CT scan reports. CLINICAL FINDINGS AND INVESTIGATIONS: A painless palpable mass was identified on examination after the patient was referred to our tertiary care hospital for surgical benefit. AFP, HCG and LDH were tested and reported normal. INTERVENTIONS AND OUTCOMES: An exploratory laparotomy was done and the mass was surgically removed and sent for histopathological examination, which revealed an ‘immature’ retroperitoneal teratoma. After resection, a rent was identified in the IVC, following which the IVC was clamped. On follow-up, the patient has been compliant and the prognosis is good. CONCLUSION: Retroperitoneal teratoma is a very rare clinical entity in adults. Being such massive, it can remain asymptomatic to be detected incidentally. Diagnosis is made with help of radiological findings and can be confirmed after surgical resection and histopathological examination. Surgery remains the mainstay of treatment.