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Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding

Received: 13 August 2021     Accepted: 24 August 2021     Published: 31 August 2021
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Abstract

Background: Teratomas are tumors that arise from germ cells in mature gonads and along the midline as extragonadal teratomas. The latter are infrequent, with few cases having been described in the pancreas. Objective: Our aim is to emphasize the importance of determining the histological features of extragonadal teratomas. Case presentation: We present the case of a mature cystic teratoma in the pancreas with focal neuroendocrine differentiation identified in a thirty-five year old male patient with no apparent symptomatology of a pancreatic tumor. The tumor was an unexpected finding made upon a diagnostic approach for SARS-CoV-2 infection. Discussion: At present, there are around fifty reported cases of teratomas in the pancreas. The majority of these are dermoid cysts. Few are mature cystic teratomas, and there is one reported case of an immature teratoma. Of the mature cystic teratomas reported in the literature, one presented a somatic neoplasm. Conclusion: The case highlights the importance on determining the histological features of extragonadal teratomas, including each type of tissue, the degree of differentiation and the presence of benign or malignant neoplasms, as these elements are key to classify teratomas appropriately.

Published in World Journal of Medical Case Reports (Volume 2, Issue 3)
DOI 10.11648/j.wjmcr.20210203.16
Page(s) 55-61
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Germ Cell Tumors, Extragonadal Teratoma, Mature Teratoma, Pancreas, Pathology

References
[1] Tumours of the ovary, “Tumours of the ovary,” in WHO Classification of Tumours of Female Reproductive Organs, 4th ed., R. J. Kurman, M. L. Carcangiu, C. S. Herrington, and R. H. Young, Eds. Geneva: WHO Press, 2014.
[2] L. Degrate et al., “Mature Cystic Teratoma of the Pancreas. Case Report and Review of the Literature of a Rare Pancreatic Cystic Lesion,” Journal of the Pancreas, vol. 13, no. 1, pp. 66–72, 2012, [Online]. Available: http://www.serena.unina.it/index.php/
[3] P. Hegde, “Extragonadal omental teratoma: A case report,” Journal of Obstetrics and Gynaecology Research, vol. 40, no. 2, Feb. 2014, doi: 10.1111/jog.12198.
[4] J. Scheele, T. F. Barth, M. Wittau, M. Juchems, D. Henne-Bruns, and M. Kornmann, “Cystic teratoma of the Pancreas,” Anticancer Research, vol. 32, pp. 1075–1080, 2012.
[5] M. de Felici, F. G. Klinger, F. Campolo, C. R. Balistreri, M. Barchi, and S. Dolci, “To be or not to be a germ cell: The extragonadal germ cell tumor paradigm,” International Journal of Molecular Sciences, vol. 22, no. 11. MDPI AG, Jun. 01, 2021. doi: 10.3390/ijms22115982.
[6] J. W. Oosterhuis and L. H. J. Looijenga, “Human germ cell tumours from a developmental perspective,” Nature Reviews Cancer, vol. 19, no. 9. Nature Publishing Group, pp. 522–537, Sep. 01, 2019. doi: 10.1038/s41568-019-0178-9.
[7] J. K. Mckenney, A. Heerema-Mckenney, and R. v Rouse, “Extragonadal Germ Cell Tumors: A Review With Emphasis on Pathologic Features, Clinical Prognostic Variables, and Differential Diagnostic Considerations,” Advances in Anatomical Pathology, vol. 14, no. 2, pp. 69–92, 2007.
[8] E. J. O’Donovan, K. Thway, and E. C. Moskovic, “Extragonadal teratomas of the adult abdomen and pelvis: a pictorial review,” The British journal of radiology, vol. 87, no. 1041, p. 20140116, Sep. 2014, doi: 10.1259/bjr.20140116.
[9] H. Sun et al., “The differences between gonadal and extra-gonadal malignant teratomas in both genders and the effects of chemotherapy,” BMC Cancer, vol. 19, no. 1, Dec. 2019, doi: 10.1186/s12885-019-5598-0.
[10] J. Lane, A. Vance, D. Finelli, G. Williams, and P. Ravichandran, “Dermoid cyst of the pancreas: A case report with literature review,” Journal of Radiology Case Reports, vol. 6, no. 12, pp. 17–25, Dec. 2012, doi: 10.3941/jrcr.v6i12.1152.
[11] J. L. Decourcy, “Dermoid Cyst of the Pancread,” Annals of Surgery, vol. 118, no. 3, pp. 394–395, 1943.
[12] C. Iacono et al., “Dermoid Cyst of the Head of the Pancreas Area,” International Journal of Pancreatology, vol. 14, no. 3, pp. 269–273, 1993.
[13] J. E. Jacobs and B. J. Dinsmore, “Mature Cystic Teratoma of the Pancreas: Sonographic and CT Findings,” American Roentgen Ray Society, vol. 160, pp. 523–524, 1993, [Online]. Available: www.ajronline.org
[14] M. Kela, S. Singh, and B. Lahoti, “Immature cystic teratoma of head of pancreas,” 2008. [Online]. Available: https://www.jiaps.com/printarticle.asp?issn=0971-9261;year=2008;volume=13;issue=2;spage=85;epage=87;aulast=Kela
[15] V. Markovsky and V. Russin, “Fine-Ndeedle Aspiration of Dermoid Cyst of the Pacnreas,” Diagnostic Cytopathology, vol. 9, no. 1, pp. 66–69, 1993.
[16] M. Mester et al., “Cystic Teratomas of the Pancreas,” Archives of Surgery, vol. 125, pp. 1215–1218, 1990, [Online]. Available: http://archsurg.jamanetwork.com/
[17] E. Rivkine et al., “Tératome kystique du pancréas,” Gastroenterologie Clinique et Biologique, vol. 31, no. 11, pp. 1016–1019, 2007, doi: 10.1016/S0399-8320(07)78323-9.
[18] J. Salimi, M. Karbakhsh, S. Dolatshahi, M. ; Seyyed, and A. Ahmadi, “Cystic teratoma o f the pancreas: a case report,” Ann Saudi Med, vol. 24, no. 3, pp. 206–209, 2004, [Online]. Available: www.kfshrc.edu.sa/annals
[19] M. Seki et al., “Image-diagnostic features of mature cystic teratomas of the pancreas: Report on two cases difficult to diagnose preoperatively,” Journal of Hepato-Biliary-Pancreatic Surgery, vol. 12, no. 4, pp. 336–340, Aug. 2005, doi: 10.1007/s00534-005-0994-z.
[20] G. Strasser, M. Kutilek, P. Mazal, and W. Schima, “Mature teratoma of the pancreas: CT and MR findings,” European Radiology, vol. 12, no. SUPPL. 3, 2002, doi: 10.1007/s00330-002-1407-1.
[21] G. Tucci et al., “Dermoid cyst of the pancreas: Presentation and management,” World Journal of Surgical Oncology, vol. 5. Aug. 03, 2007. doi: 10.1186/1477-7819-5-85.
[22] C. W. Yu, K. L. Liu, W. C. Lin, and Y. W. Li, “Mature cystic teratoma of the pancreas in a child,” Pediatric Radiology, vol. 33, no. 4, pp. 266–268, Apr. 2003, doi: 10.1007/s00247-003-0872-2.
[23] A. Y. Zhang, S. K. Thompson, P. A. Game, and J. J. Allin, “Cystic teratoma of the pancreas: A rare entity,” ANZ Journal of Surgery, vol. 78, no. 12, pp. 1130–1131, Dec. 2008, doi: 10.1111/j.1445-2197.2008.04766.x.
[24] D. Campani, G. Gallippi, M. Granai, N. de Lio, and U. Boggi, “Dermoid cyst of the pancreas,” International Journal of Colorectal Disease, vol. 28, no. 4. pp. 597–598, Apr. 2013. doi: 10.1007/s00384-012-1506-7.
[25] C. Kellen et al., “Dermoid cyst of the pancreas: a case report,” J Bras Patol Med Lab, vol. 49, no. 5, pp. 324–346, 2013.
[26] J. Razman et al., “An interesting case of isolated pancreatic teratoma: lessons to learn Case report,” Clin Ter, vol. 163, no. 6, pp. 495–497, 2012.
[27] P. C. Das and P. L. N G Rao, “Cystic teratoma of the pancreas,” 1996.
[28] Y. Wang et al., “Childhood cystic teratoma of the pancreas: Clinical presentation, evaluation and management,” Pancreatology, vol. 14, no. 4, pp. 312–315, 2014, doi: 10.1016/j.pan.2014.03.021.
[29] Z. Li, N. Ke, X. Liu, and S. Gong, “Mature cystic teratoma of the pancreas with 30 years of clinical course: A case report,” Medicine (United States), vol. 97, no. 15, Apr. 2018, doi: 10.1097/MD.0000000000010405.
[30] J. Scheele, T. F. E. Barth, J. Straburg, M. Juchems, M. Kornmann, and D. Henne-Bruns, “Dermoid cyst of the pancreas,” International Journal of Colorectal Disease, vol. 25, no. 3. pp. 415–416, Mar. 2010. doi: 10.1007/s00384-009-0811-2.
[31] X. H. Zhou, J. K. Ma, B. Valluru, K. Sharma, L. Liu, and J. B. Hu, “Diagnosis and differentiation of mature cystic teratoma of pancreas from its mimics: A case report,” Medicine, vol. 99, no. 47, p. e23267, Nov. 2020, doi: 10.1097/MD.0000000000023267.
[32] A. Albayrak, U. Yildirim, and M. Aydin, “Dermoid Cyst of the Pancreas: A Report of an Unusual Case and a Review of the Literature,” Case Reports in Pathology, vol. 2013, pp. 1–5, 2013, doi: 10.1155/2013/375193.
[33] D. K. Chakaravarty et al., “Mature Cystic Teratoma of the Pancreas,” ACG Case Reports Journal, vol. 3, no. 1, pp. 80–81, 2016, doi: 10.14309/crj.2016.5.
[34] A. Ahmed, L. Peng, and D. Agrawal, “Mature cystic teratoma of the pancreas: Role of endoscopic ultrasound,” Pancreatology, vol. 15, no. 4, pp. 445–448, Jul. 2015, doi: 10.1016/j.pan.2015.05.469.
[35] K. J. Koomalsingh, R. Fazylov, M. I. Chorost, and J. Horovitz, “Cystic Teratoma of the Pancreas: Presentation, Evaluation and Management,” 2006. [Online]. Available: http://www.joplink.net
[36] S. E. Lee, Y. S. Choi, S. U. Hong, H. C. Oh, and E. S. Lee, “Dermoid cyst of the pancreas: A rare cystic neoplasm,” International Journal of Surgery Case Reports, vol. 17, pp. 72–74, 2015, doi: 10.1016/j.ijscr.2015.10.026.
[37] A. Casajoana Badia, N. Pelaez Sera, J. Fabregat Prous, T. Serrano Piñol, and C. Valls serra, “Cystic teratoma of the pancreas,” Cirugia Espanola, vol. 88, no. 6, pp. 414–430, Dec. 2010, doi: 10.1016/j.ciresp.2010.01.005.
[38] A. Daghfous et al., “Mature teratoma of the pancreas diagnosed by fine-needle aspiration,” Arab Journal of Gastroenterology, vol. 12, no. 2, pp. 92–93, Jun. 2011, doi: 10.1016/j.ajg.2011.04.009.
[39] D. A. Lyons, E. A. Coberly, G. M. Hammoud, and M. B. Nicholl, “Case Report of Pancreatic Dermoid Cyst: Can Fine Needle Aspiration Make the Diagnosis?,” Journal of the Pancreas, vol. 14, no. 6, pp. 653–656, 2013, [Online]. Available: http://www.serena.unina.it/index.php/
[40] E. Ofori, D. Ramai, D. Etienne, M. Reddy, and G. Shahzad, “Large Dermoid Cyst Presenting as Recurrent Pancreatitis,” Gastroenterology Research, vol. 10, no. 5, pp. 322–324, 2017, doi: 10.14740/gr876w.
[41] H. ben Ameur, S. Boujelbene, C. Abdelhedi, O. Gheriani, and M. I. Beyrouti, “Mature cystic teratoma of the pancreas,” Updates in Surgery, vol. 64, no. 4, pp. 311–314, Dec. 2012, doi: 10.1007/s13304-011-0116-1.
[42] J. Wang et al., “Primary mixed germ cell tumor arising in the pancreatic head,” Journal of Pediatric Surgery, vol. 48, no. 1, Jan. 2013, doi: 10.1016/j.jpedsurg.2012.10.054.
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    Juan Jose Andrade-Rojas, María José Lizardo-Thiebaud, Guillermo Andrade-Orozco, Leonel Contreras-Loera, Nelsy Liseth Garza-Hinojosa, et al. (2021). Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding. World Journal of Medical Case Reports, 2(3), 55-61. https://doi.org/10.11648/j.wjmcr.20210203.16

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    ACS Style

    Juan Jose Andrade-Rojas; María José Lizardo-Thiebaud; Guillermo Andrade-Orozco; Leonel Contreras-Loera; Nelsy Liseth Garza-Hinojosa, et al. Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding. World J. Med. Case Rep. 2021, 2(3), 55-61. doi: 10.11648/j.wjmcr.20210203.16

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    AMA Style

    Juan Jose Andrade-Rojas, María José Lizardo-Thiebaud, Guillermo Andrade-Orozco, Leonel Contreras-Loera, Nelsy Liseth Garza-Hinojosa, et al. Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding. World J Med Case Rep. 2021;2(3):55-61. doi: 10.11648/j.wjmcr.20210203.16

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  • @article{10.11648/j.wjmcr.20210203.16,
      author = {Juan Jose Andrade-Rojas and María José Lizardo-Thiebaud and Guillermo Andrade-Orozco and Leonel Contreras-Loera and Nelsy Liseth Garza-Hinojosa and Maria Guadalupe Jazmín De Anda-Gonzalez},
      title = {Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding},
      journal = {World Journal of Medical Case Reports},
      volume = {2},
      number = {3},
      pages = {55-61},
      doi = {10.11648/j.wjmcr.20210203.16},
      url = {https://doi.org/10.11648/j.wjmcr.20210203.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20210203.16},
      abstract = {Background: Teratomas are tumors that arise from germ cells in mature gonads and along the midline as extragonadal teratomas. The latter are infrequent, with few cases having been described in the pancreas. Objective: Our aim is to emphasize the importance of determining the histological features of extragonadal teratomas. Case presentation: We present the case of a mature cystic teratoma in the pancreas with focal neuroendocrine differentiation identified in a thirty-five year old male patient with no apparent symptomatology of a pancreatic tumor. The tumor was an unexpected finding made upon a diagnostic approach for SARS-CoV-2 infection. Discussion: At present, there are around fifty reported cases of teratomas in the pancreas. The majority of these are dermoid cysts. Few are mature cystic teratomas, and there is one reported case of an immature teratoma. Of the mature cystic teratomas reported in the literature, one presented a somatic neoplasm. Conclusion: The case highlights the importance on determining the histological features of extragonadal teratomas, including each type of tissue, the degree of differentiation and the presence of benign or malignant neoplasms, as these elements are key to classify teratomas appropriately.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Mature Cystic Teratoma in the Head of the Pancreas: An Unexpected Finding
    AU  - Juan Jose Andrade-Rojas
    AU  - María José Lizardo-Thiebaud
    AU  - Guillermo Andrade-Orozco
    AU  - Leonel Contreras-Loera
    AU  - Nelsy Liseth Garza-Hinojosa
    AU  - Maria Guadalupe Jazmín De Anda-Gonzalez
    Y1  - 2021/08/31
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    N1  - https://doi.org/10.11648/j.wjmcr.20210203.16
    DO  - 10.11648/j.wjmcr.20210203.16
    T2  - World Journal of Medical Case Reports
    JF  - World Journal of Medical Case Reports
    JO  - World Journal of Medical Case Reports
    SP  - 55
    EP  - 61
    PB  - Science Publishing Group
    SN  - 2994-726X
    UR  - https://doi.org/10.11648/j.wjmcr.20210203.16
    AB  - Background: Teratomas are tumors that arise from germ cells in mature gonads and along the midline as extragonadal teratomas. The latter are infrequent, with few cases having been described in the pancreas. Objective: Our aim is to emphasize the importance of determining the histological features of extragonadal teratomas. Case presentation: We present the case of a mature cystic teratoma in the pancreas with focal neuroendocrine differentiation identified in a thirty-five year old male patient with no apparent symptomatology of a pancreatic tumor. The tumor was an unexpected finding made upon a diagnostic approach for SARS-CoV-2 infection. Discussion: At present, there are around fifty reported cases of teratomas in the pancreas. The majority of these are dermoid cysts. Few are mature cystic teratomas, and there is one reported case of an immature teratoma. Of the mature cystic teratomas reported in the literature, one presented a somatic neoplasm. Conclusion: The case highlights the importance on determining the histological features of extragonadal teratomas, including each type of tissue, the degree of differentiation and the presence of benign or malignant neoplasms, as these elements are key to classify teratomas appropriately.
    VL  - 2
    IS  - 3
    ER  - 

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Author Information
  • Department of Anatomic Pathology, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico

  • Department of Anatomic Pathology, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico

  • Department of Anatomic Pathology, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico

  • Department of Anatomic Pathology, Hospital Central Doctor Ignacio Morones Prieto, San Luis Potosi, Mexico

  • Department of Dermatology, Centro Medico Nacional del Noroeste UMAE25, Nuevo Leon, Mexico

  • Department of Anatomic Pathology, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico

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