Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
CASE STUDY   (Open Access)

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*

+ Author Affiliations

Journal of Angiotherapy 6(1) 1-4 https://doi.org/10.25163/angiotherapy.6162190290707122

Submitted: 29 November 2021  Revised: 11 December 2021  Published: 07 January 2022 

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.

References

Alborzi, S., Foroughinia, L., Kumar, P. V., & Jamal, A. (2009). A comparison of histopathologic findings of ovarian tissue inadvertently excised with endometrioma and other kinds of benign ovarian cyst in patients undergoing laparoscopy versus laparotomy. Fertility and Sterility, 92(6), 2004-2007. https://doi.org/10.1016/j.fertnstert.2008.09.006

Besser, M. J., & Posey, D. M. (1992). Cystic teratoma in a supernumerary ovary of the greater omentum: A case report. Journal of Reproductive Medicine, 37(3), 189-193.

Can J Surg. (2009). Benign teratoma of the omentum and ovary coexistent with an ovarian neoplasm. Canadian Journal of Surgery, 52(3), E54-55. https://doi.org/10.1007/BF03085503

Caspi, B., Appelman, Z., Rabinerson, D., & Bar-Hava, I. (1997). The growth pattern of ovarian dermoid cysts: A prospective study in premenopausal and postmenopausal women. Fertility and Sterility, 68(3), 501-505. https://doi.org/10.1016/S0015-0282(97)00223-6

Chen, S. S., Chen, C. P., Chien, S. C., et al. (2008). Spontaneous rupture of omental teratoma mimicking a ruptured ovarian teratoma. Taiwan Journal of Obstetrics and Gynecology, 47(2), 229-232. https://doi.org/10.1016/S1028-4559(08)60048-1

Deppe, G., Malviya, V. K., & Jacobs, A. J. (1988). Extragonadal, mature, solid teratoma with omental implants: A case report. Journal of Reproductive Medicine, 33(9), 792-794.

Drut, R., Drut, R. M., & Vollaro, F. (1990). Mature cystic teratoma of the greater omentum. Pediatric Pathology, 10(6), 1033-1035. https://doi.org/10.3109/15513819009034289

Ekbladh, L. E., & Fishburne, J. I. (1973). Parasitized dermoid cyst of the omentum. Obstetrics and Gynecology, 42(3), 458-460.

Furuhashi, M., Katsumata, Y., Oda, H., et al. (1997). Cystic teratoma of the greater omentum: A case report and review of the literature. Journal of Obstetrics and Gynaecology Research, 23(4), 359-363. https://doi.org/10.1111/j.1447-0756.1997.tb00786.x

Kearney, M. S. (1983). Synchronous benign teratomas of the greater omentum and ovary: Case report. British Journal of Obstetrics and Gynaecology, 90(7), 676-679. https://doi.org/10.1111/j.1471-0528.1983.tb02979.x

Kurata, A., Hirano, K., Nagane, M., et al. (2010). Immature teratoma of the ovary with distant metastases: Favorable prognosis and insights into chemotherapeutic retroconversion. International Journal of Gynecological Pathology, 29(4), 438-444. https://doi.org/10.1097/PGP.0b013e3181d52f79

Mazumdar, A., Vaiphei, K., & Verma, G. R. (1997). Multiple dermoid cysts of omentum. Journal of Postgraduate Medicine, 43(1), 41-42.

Moon, W., Kim, Y., Rhim, H., et al. (1997). Coexistent cystic teratoma of the omentum and ovary: Report of two cases. Abdominal Imaging, 22(6), 516-518. https://doi.org/10.1007/s002619900151

Richardson, R., Sharma, A., & Hammond, R. (2011). Immature teratoma of the greater omentum. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 159(2), 478-479. https://doi.org/10.1016/j.ejogrb.2011.07.020

SARAVANAN, G. (2017). Teratoma of greater omentum presenting as a right iliac fossa mass. University Journal of Surgery and Surgical Specialties, 3(1).

Smith, R., Deppe, G., Selvaggi, S., et al. (1990). Benign teratoma of the omentum and ovary coexistent with an ovarian neoplasm. Gynecologic Oncology, 39(3), 204-207. https://doi.org/10.1016/0090-8258(90)90148-E

Ushakov, F. B., Meirow, D., Prus, D., et al. (1998). Parasitic ovarian dermoid tumor of the omentum. A review of the literature and report of two new cases. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 81, 77-82. https://doi.org/10.1016/S0301-2115(98)00144-4

Yoshida, A., Murabayashi, N., Shiozaki, T., et al. (2005). Case of mature cystic teratoma of the greater omentum misdiagnosed as ovarian cyst. Journal of Obstetrics and Gynaecology Research, 31(5), 399-403. https://doi.org/10.1111/j.1447-0756.2005.00340.x

Zhang, W., & Chen, X. (2010). Omental teratoma: A rare case and review of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology, 149(1), 3-7. https://doi.org/10.1016/j.ejogrb.2010.09.003

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