Retroperitoneal teratomas--potential for surgical misadventure.
BACKGROUND
Retroperitoneal teratoma (RPT) is a relatively uncommon tumor in children. This study concerns 6 children with RPT that involved surrounding structures and required rather extensive operative procedures to successfully excise the lesions.


METHODS
A review of RPT in children encountered at a single institution over an 8-year period by a single surgeon was carried out. Age at presentation, sex, operative findings, surgical management, and outcomes were evaluated.


RESULTS
Four of the 6 patients were girls, and 5 were younger than 6 months at diagnosis. All of the tumors enveloped and displaced the aorta and vena cava, 1 involved the stomach wall, 2 others displaced the renal vessels, and 1 the portal vein. Extensive resection including major vessel ligation was necessary for complete excision. All the tumors were benign, but 1 recurred. There were no deaths; however, 2 children have persistent hypertension.


CONCLUSIONS
The operative management of RPTs may be complex and challenging. Despite their benign nature, the lesions can attenuate and surround major vessels, making resection difficult. Ligation of major vessels when necessary is tolerated well and may be required for complete tumor excision.
Jones
Niall M
NM
Great Ormond Street Children's Hospital, London, WC1N 3JH, UK.
Kiely
Edward M
EM
D001707:Biopsy, Needle; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007813:Laparotomy / Q000379:methods; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D013724:Teratoma / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D006113:United Kingdom; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000601:surgery