Teratomas in Adrenal and Retroperitoneal Regions

Teratomas in the adrenal and retroperitoneal regions represent a rare subset of extragonadal germ cell tumours, arising from pluripotent cells that have failed to migrate to gonadal sites during embryogenesis. They may contain elements from all three germ layers and range from benign mature cystic lesions to malignant or immature variants. These tumours often present incidentally on imaging or with non-specific symptoms such as abdominal discomfort, flank pain or a palpable mass. Diagnosis relies on cross-sectional modalities, principally computed tomography and magnetic resonance imaging, which characteristically reveal heterogeneous masses with fat, calcification and fluid components. Serum markers including alpha-fetoprotein and beta-human chorionic gonadotrophin can assist in distinguishing immature or malignant elements but are variably elevated. The cornerstone of management is complete surgical excision, which may be achieved via open, laparoscopic or retroperitoneoscopic approaches depending on tumour size, location and relation to major vessels. Careful preoperative planning is essential to mitigate risks of vascular injury and organ displacement. Long-term outcome is generally favourable for mature lesions, though recurrences and malignant transformation warrant structured follow-up.

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Teratomas in Adrenal and Retroperitoneal Regions publication trend

The graph below shows the total number of articles in teratomas in adrenal and retroperitoneal regions across all publications each year (not limited to Nature Index journals).

Technical terms

Teratoma: A neoplasm composed of tissues derived from more than one embryonic germ layer (ectoderm, mesoderm, endoderm).

Germ cell tumour: A neoplasm originating from primordial germ cells, capable of differentiating into multiple tissue types.

Retroperitoneum: The anatomical space behind the peritoneal cavity, containing the kidneys, adrenal glands, pancreas and major vessels.

En bloc resection: Surgical removal of a tumour and surrounding tissues in one single piece to ensure clear margins.

Minimally invasive surgery: Techniques such as laparoscopy or retroperitoneoscopy that use small incisions to reduce patient morbidity.

References

1. Laparoscopic resection of a huge mature cystic teratoma of the right adrenal gland through retroperitoneal approach: a case report and literature review. World Journal of Surgical Oncology (2015).
2. Giant Mature Primary Retroperitoneal Teratoma in a Young Adult: Report of a Rare Case and Literature Review. Case Reports in Surgery (2014).
3. Giant Primary Retroperitoneal Teratoma in an Adult: A Case Report. Case Reports in Medicine (2010).
4. Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22‐Year‐Old Male: A Case Report and Literature Review. Case Reports in Oncological Medicine (2013).
5. Primary mature adrenal teratoma in infant. Pan African Medical Journal (2020).
6. Surgical Anatomy of Large Retroperitoneal Teratomas in Infants: Report of Two Cases. Clinical Medicine Insights Case Reports (2008).
7. Surgical challenges of excision of retroperitoneal germ cell tumors in children: a single institutional study with literature review. Annals of Pediatric Surgery (2021).
8. Case Reports: Management Challenges in Pediatric Germ Cell Tumors. Frontiers in Pediatrics (2021).