An endodermal sinus tumor arising from a mature cystic teratoma in the retroperitoneum in a child: is a mature teratoma a premalignant condition?
We herein report an 18-month-old girl who presented with a retroperitoneal mature teratoma that later developed into an endodermal sinus tumor. Her symptoms included an expanding abdominal girth. The serum levels of alpha-fetoprotein were moderately elevated. The excised specimen was a benign mature cystic retroperitoneal teratoma measuring 18 x 11 x 8 cm in size. A hemorrhagic focus measuring 4 cm in diameter was present, which proved to be the focus of an endodermal sinus tumor histologically. The retroperitoneal mature teratoma observed in this case showed malignant germ-cell differentiation. The above case is thought to be extremely rare, but these findings also suggest the possibility of a mature teratoma presenting as a premalignant condition. The sequence of "mature teratoma--germ-cell malignancy" is thus considered to represent a new potential pattern of early phase of carcinogenesis in teratomas.
Department of Surgery II, Nagasaki University School of Medicine, Sakamoto, Japan.
Y
Y
Ohno
T
T
Kanematsu
D006063:Chorionic Gonadotropin / Q000097:blood; D003560:Cysts / Q000473:pathology; D003937:Diagnosis, Differential; D018240:Endodermal Sinus Tumor / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013724:Teratoma / Q000175:diagnosis / Q000473:pathology*; D000509:alpha-Fetoproteins / Q000032:analysis
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins