Mesenteric teratoma

Case contributed by Dr Ololu-Zubair Hajarat .T.

Presentation

Chronic abdominal pain of about 2 years duration, occasional vomiting, constipation and anemia

Patient Data

Age: 3 years
Gender: Male
X-ray

Abdominal radiograph shows soft tissue mass with central calcifications in the left hemiabdomen adjacent to L3 vertebra  

Ultrasound

A mixed echogenic (hyperechoic with distant acoustic shadowing and hypoechoic) mass is noted in the left upper abdomen, anterior to the left kidney. It measures 55 x 63 x 40 mm. Abdominal CT was requested to further characterize the lesion

CT

There is a large mixed density mass, related to proximal jejunal bowel loops mesentery in the left upper abdomen,  anterior to the left kidney. The mass measures about 5 x 6 x 4 cm and shows fatty density with multiple intralesional calcifications (teeth \ bones). The appearance is in keeping with mesenteric teratoma.

Case Discussion

Even though teratomas are usually asymptomatic, they sometimes present with symptoms due to local compression as is with this case where the child presented with chronic abdominal pain, occasional vomiting, constipation and refusal of feeds which led to anemia on two occasions. This prompted further investigations and the characteristic presence of tooth-like structures, bones and fat components are characteristic for teratomas. However, child was referred to a higher center for surgery and histopathology confirmation.

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Case information

rID: 74231
Published: 19th Feb 2020
Last edited: 19th Feb 2020
Inclusion in quiz mode: Included

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