| A Case of Intraperitoneal Teratoma |
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Choon Yul Rim, Kyung Yong Huh |
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Department of Pediatrics, Chonnam University Medical School |
| 복막강내 기형종 1예 |
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임춘열, 허경룡 |
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전남대학교 의과대학 소아과학교실 |
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| Abstract |
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Teratoma is rare but one of major intra-abdominal congenital tumors such as Wilm’s tumor and neuroblastoma in childhood. This tumor represents abnormal development of fetal tissue remnants and is composed of the tissue derived from three embryonic layer. Although teratoma has been observed in many locations such as sacrococcygeal area, ovary, retroperitoneal cavity, intraperitoneal cavity, mediastinum, liver and brain ect., sacrococcygeal area is the most common predirection site in childhood. Considerable number of cases about the sacrococcygeal and retroperitoneal teratomas have been reported in Korea but it is thought that any intraperitoneal teratoma has not been reported up to date. Authors experienced a case of intraperitoneal teratoma as following. A 24 day old male newborn infant was admitted to the department of Pediatrics in Chonnam Univ- ersity Hospital on the 2nd June, 1973, because of abdominal distension and dyspnea. He was
delivered at full term and had no specific past and family history which might "contribute to fetal malformation. At birth the distended abdomen was noted and has increased gradually day by day. Weak sucking power, foamy stool and intermittent fever has been developed 15 days after birth, and dyspnea 7 days later. At the time of admission he was pale, lethargic and dehydrated. The weight, height and head circumference were under the 3rd percentile. Auscultation of the chest revealed moist rales on both lung fields, and a child fist sized soft mass with fluid wave was palpated on the epigastric region, which was suggested to be composed of cystic and solid part. Laboratory data showed no specific findings except mild anemia and low plasma protein. Staphylococcus aureus was cultured in the throat swab. Chest X-ray showed irregular pneumonic infiltration in both lung fields indicating bilateral bronchopneumonia, plain film of abdomen revealed a child fist sized round mass density in the region of the epigastrium. There was shown round pressure effect on the lesser curvature and antrum, of the stomach, and displacement of the stomach downward laterally and anteriorly in the upper G-I series.
Marked downward displacement of the splenic flexure and transverse colon without any evidence of involvement was noted in the colon study but I.V.P. showed no abnormal findings. Autopsy revealed that a 12X9X7. 5cm sized mass was located below the liver and in the ventral part of the posterior peritoneum, adjacent to the lesser curvature of the stomach and the second portion of the duodenum. Stomach was pushed left anterioly, and colon and small intestines inferiorly but no adhesion to the organs around it.
The tumor was 220 gm in weight and the cystic part contained about 90cc of orange colored serous fluid and the solid part was composed of cartilarge, muscle, fat and some hair. Mieroscopically the specimen from the base of the cyst showed various tissues derived from three embrionic layers, and skin appendage, smooth muscles, fat and cartilage cells were found in the specimen from the solid part but no evidence of malignant tumor. |
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