Purpose or Case Report: Teratomas are the most frequent germ cell tumors. According to their histology, they can be divided into mature and immature, the latter with aggressive and a higher rate of recurrence. They can be located along the entire midline, with the gonadal location being the most frequent. In extragonadal the most frequent is at the sacrococcygeal, mediastinal, cervicofacial, and retroperitoneal levels. Retroperitoneal teratomas account for 3-4% of all germ cell tumors and are preferentially located in the pararenal area. Less frequent are pericardial teratomas, the vast majority being of the mature type. These require urgent resection, which is mainly determined by possible complications such as pericardial effusion and cardiac tamponade.
Results: Case 1, a 14-month-old female patient, healthy, under study for gastroesophageal reflux with US finding of a right adrenal mass, with suspicion of neuroblastomas. MRI showed a right adrenal solid mass, hyperintense in T1 and T2 sequences, with a signal drop in low suppression sequences, compatible with a teratoma that was resected without incident. Case 2, a 6-year-old male patient with a retroperitoneal mass detected as a finding in an abdominal ultrasound, it was separated and heterogeneous to US, with suspicion of a low-flow vascular malformation of the lymphoid type. MRI showed a metacystic lesion, with a single vascular pedicle, some loculi with thickened walls and areas of polypoid appearance inside, hypertrophic polypoid areas in its interior, hyperintense in T1 and hypointense in T2 suggestive of hematic/proteinaceous content. Case 3, female patient with a thoracic mass associated with pericardial effusion on prenatal US. A fetal MRI confirmed a lesion with a cystic appearance, with an area compatible with fat highly suggestive of a pericardial teratoma associated with effusion. In all cases, the excisional biopsy of the lesions was compatible with mature teratomas.
Conclusions: Most teratomas are of gonadal location. The extragonadal, as in our cases, are less frequent and tend to be benign in behavior. Careful analysis of the images, especially the presence of fat associated with cystic and variable solid content, may suggest the nature of these lesions. Regardless of their appearance and location, the management of all teratomas is surgical resection.
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