Rare Case of Mature Teratoma in the Greater Omentum: Diagnostic and Surgical Challenges

Brigida  S ¹, Parijatham S ², Lakshmi Prabha M ³, Saravanan K ⁴*

This rare case of greater omental teratoma determines diagnostic challenges and underscores the importance of surgical intervention for accurate diagnosis and treatment.

Abstract

Background: Teratomas are germ cell tumors characterized by the presence of tissues from all three embryonic germ layers. While mature teratomas are commonly found in the ovaries, their occurrence in the greater omentum is extremely rare, with only 29 cases reported globally. Methods: This case report details the presentation, diagnostic evaluation, and management of a 44-year-old female who presented with dull, aching pain and vague fullness in the right iliac fossa. Diagnostic imaging, including ultrasound and contrast-enhanced computed tomography (CECT), revealed an ill-defined solid and cystic lesion in the right iliac fossa, suspected to arise from the small bowel mesentery or ovary. Preoperative diagnosis was considered to be either an ovarian tumor or a small bowel mesentery tumor. The patient underwent elective laparotomy with partial omentectomy. Results: Surgical exploration identified an 8x6 cm bluish-grey solid and cystic lesion attached to the greater omentum, with the right ovary and appendix absent. The lesion was excised along with the attached omentum. Histopathological examination confirmed the presence of a mature teratoma. Conclusion: Teratomas of the greater omentum are exceptionally rare, and accurate preoperative diagnosis can be challenging. Surgical intervention, including complete excision, remains the primary treatment approach. This case highlights the importance of considering rare tumor locations in differential diagnoses and the effectiveness of surgical management in achieving favorable outcomes.

Keywords: Teratoma, Greater omentum, Germ cell tumors, Ovarian tumor, Surgical excision.

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