Clinical Pattern and Management of Retroperitoneal Teratomas in a Tertiary Paediatric Centre: A Retrospective Study

Abstract

Introduction: Retroperitoneal Teratomas (RPT) are rare germ cell tumours. Preoperative imaging features often overestimate the tumour size and may be misleading. Surgical exploration of RPT is a challenge because of enormous size and adherence to surrounding organs. The current knowledge on childhood RPT is limited due to rarity of these cases and limited number of studies. Aim: To analyse the demographic pattern, clinical profile and outcome of RPTs managed in a tertiary care paediatric hospital. Materials and Methods: This retrospective study was conducted on hospital records of the children between June 2013 and May 2020. The diagnosis was based on clinical, radiological, intraoperative findings and histopathology and data were collected for demographic pattern, clinical findings, pathological features and outcomes. Statistical analysis was done using Microsoft Excel software. Fisher’s-exact test was used for comparison between various groups. Results: Out of 88 cases of intra-abdominal solid tumours operated during the study period, RPT was found in 16 cases (18.18%). A male preponderance was observed among RPT patients in comparison to other intra-abdominal solid tumours (p=0.26) and 12 patients (75%) were below five years of age. Complete excision of teratoma was performed in all cases. Benign mature teratoma was detected in 81% cases and immature teratoma in 18%. Additionally, two rare observations were made in the present study: (i) In one patient, the histology revealed; teratoma with papillary carcinoma of thyroid as malignant component and chemotherapy was advised; (ii) renal atrophy secondary to RPT was found in another patient. There was no mortality or tumour recurrence; as monitored by serum Alpha-Fetoprotein (AFP). Conclusion: RPTs are uncommon childhood tumours, which usually present before five years of age. Complete excision is possible, without damage to surrounding organs, as they are mostly benign. But, finding of malignant component in the tumour warrants further chemotherapy.