Renal immature teratoma in infant: A rare case report

Abstract

Renal teratoma is a rare malignant tumour originating from pluripotent cells. A five-month-old female presented with a painless abdominal mass initially suspected to be a Wilms tumor. A CT scan showed a large tumor in the left abdomen, leading to a left open nephrectomy. Histopathology confirmed an immature Grade III teratoma, showing ectodermal, mesodermal, and endodermal components with neuroepithelial structures. Post-operatively, the patient was stable with a good surgical wound. Diagnosis of renal teratoma relies on histology, as pre-operative imaging may mimic other tumors. Surgical removal is the primary treatment, with chemotherapy for recurrence if necessary.

Highlights

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We report the case of a five-month-old female with painless abdominal mass.
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Initial diagnosis was Wilms’ tumor, while biopsy showed immature renal teratoma.
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The patient underwent left open nephrectomy and complete resection of the tumor.

1 Introduction

The histological characteristic of an immature teratoma is immature tissue. It is a germinal malignant tumor derived from pluripotent cells with separate layers made up of the ectoderm, endoderm, and mesoderm. The sacrococcygeal region and the gonads are the most frequent sites of origin. Extragonadal teratomas are extremely uncommon to develop in the kidney. . According to Choi et al., there have only been twenty reported occurrences of primary renal teratomas in over 69 years, making them incredibly rare. .

The most common kidney tumor in children, Wilms’ tumor, appears as an abdominal mass and shares radiological similarities with teratomas. It develops from mesodermal metanephrogenic blastema. Both mesodermal and ectodermal tissue may be present. . In this manuscript, we present a case of renal immature teratoma in a five-month-old female patient.

2 Case presentation

A five-month-old female infant was admitted to the hospital complaining of a painless enlarged stomach since the age of three months. The bump is painless, and the patient can lie on her stomach without trouble. The patient’s mother also complained that the patient defecates only once a day. The characteristic of the patient is presented in Fig. 1 .

An abdominal contrast computed tomography (CT) scan ( Fig. 2 .) revealed a tumor occupying most of the left abdomen measuring 15 x 10 × 13 cm. The patient was suspected of having Wilms tumor.

The patient underwent left open nephrectomy in our hospital. The tumor is completely resectable ( Fig. 3 ). The specimen was sent to the Pathology Anatomy Department following the nephrectomy.

Histopathology examination ( Fig. 4 .) after surgery revealed an immature teratoma Grade III (High Grade). Tissue preparations from the kidney show a tumor mass consisting of 3 components (ectoderm, mesoderm, endoderm).