Skip to main content
SpringerLink
Log in

Adrenal Teratoma: a Case Series and Review of the Literature

  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

Adrenal teratomas are rare neoplasms and there is limited data on their surgical outcomes and long-term prognosis. We aimed to review our institutional experience and compare this to the existing literature on adrenal teratomas in adults and children. An institutional pathology database was searched for cases of adrenal teratoma (June 1956–July 2016). Clinical and imaging data were abstracted from the medical records and pathology slides were obtained for review. In addition, a PubMed search for “adrenal teratoma” from June 1952 to July 2016 was performed to identify reports of primary adrenal teratoma in patients of all ages. Of 7706 patients who underwent adrenalectomy during the study period at our institution, three patients were identified with adrenal teratoma. Patients were 24, 26, and 29 years of age, respectively. Two patients presented with abdominal pain and two of the three underwent a laparoscopic adrenalectomy. A pathologic examination revealed mature cystic teratomas that frequently displayed well-differentiated respiratory, digestive, and squamous epithelia. Eighteen case reports in the literature were identified in patients 17–61 years of age. Patients presented most frequently with abdominal or flank pain (63.6%). Median tumor diameter was 9.0 cm and tumors were frequently left-sided (81.8%), cystic (63.6%), and calcified (72.7%) on either radiologic or pathologic examination. Primary adrenal teratomas are rare neoplasms that typically present as large, left-sided nodules with cystic and calcified components seen radiographically. Although the data are limited, they are generally amenable to laparoscopic resection and have a very favorable prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bhatti A, Al-Hindi H, Azzam A, Amin T, Abu-Zaid A (2013) Mature (benign) cystic retroperitoneal teratoma involving the left adrenal gland in a 22-year-old male: a case report and literature review. Case reports in oncological medicine 2013:610280. doi:10.1155/2013/610280

    Article  PubMed  PubMed Central  Google Scholar 

  2. Castillo OA, Vitagliano G, Villeta M, Arellano L, Santis O (2006) Laparoscopic resection of adrenal teratoma. JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons 10 (4):522–524

    Google Scholar 

  3. Lam KY, Lo CY (1999) Teratoma in the region of adrenal gland: a unique entity masquerading as lipomatous adrenal tumor. Surgery 126 (1):90–94. doi:10.1067/msy.1999.98924

    Article  PubMed  CAS  Google Scholar 

  4. Gatcombe HG, Assikis V, Kooby D, Johnstone PA (2004) Primary retroperitoneal teratomas: a review of the literature. J Surg Oncol 86 (2):107–113. doi:10.1002/jso.20043

    Article  PubMed  Google Scholar 

  5. Bokemeyer C, Nichols CR, Droz JP, Schmoll HJ, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Kanz L, Einhorn L, Hartmann JT (2002) Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis. J Clin Oncol 20 (7):1864–1873

    Article  PubMed  Google Scholar 

  6. Bedri S, Erfanian K, Schwaitzberg S, Tischler AS (2002) Mature cystic teratoma involving adrenal gland. Endocrine pathology 13 (1):59–64

    Article  PubMed  Google Scholar 

  7. Rais-Bahrami S, Varkarakis IM, Lujan G, Jarrett TW (2007) Primary retroperitoneal teratoma presenting as an adrenal tumor in an adult. Urology 69 (1):185.e181–182. doi:10.1016/j.urology.2006.10.027

    Article  Google Scholar 

  8. Giordano R, Giraudo G, Forno D, Bosco M, Delsedime L, Morino M, Arvat E (2011) A case of primary retroperitoneal teratoma presenting as an adrenal incidentaloma. Journal of endocrinological investigation 34 (8):645–646. doi:10.1007/bf03345398

    Article  PubMed  CAS  Google Scholar 

  9. Li S, Li H, Ji Z, Yan W, Zhang Y (2015) Primary adrenal teratoma: clinical characteristics and retroperitoneal laparoscopic resection in five adults. Oncol Lett 10 (5):2865–2870. doi:10.3892/ol.2015.3701

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Li H, Zhao T, Wei Q, Yuan H, Cao D, Shen P, Liu L, Zeng H, Chen N (2015) Laparoscopic resection of a huge mature cystic teratoma of the right adrenal gland through retroperitoneal approach: a case report and literature review. World J Surg Oncol 13:318. doi:10.1186/s12957-015-0734-z

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sato F, Mimata H, Mori K (2010) Primary retroperitoneal mature cystic teratoma presenting as an adrenal tumor in an adult. International journal of urology: official journal of the Japanese Urological Association 17 (9):817. doi:10.1111/j.1442-2042.2010.02591.x

    Article  Google Scholar 

  12. McMillan A, Horwich A (1987) Malignant teratoma presenting with an adrenal mass. Clinical radiology 38 (3):327–328

    Article  PubMed  CAS  Google Scholar 

  13. Oguzkurt P, Ince E, Temiz A, Demir S, Akabolat F, Hicsonmez A (2009) Prenatal diagnosis of a mass in the adrenal region that proved to be a teratoma. J Pediatr Hematol Oncol 31 (5):350–351. doi:10.1097/MPH.0b013e318190d765

    Article  PubMed  Google Scholar 

  14. Li Y, Zhong Z, Zhao X (2011) Primary mature teratoma presenting as an adrenal tumor in a child. Urology 78 (3):689–691. doi:10.1016/j.urology.2010.12.022

    Article  PubMed  Google Scholar 

  15. Ciftci I, Cihan T, Koksal Y, Ugras S, Erol C (2013) Giant mature adrenal cystic teratoma in an infant. Acta Inform Med 21 (2):140–141. doi:10.5455/aim.2013.21.140-141

    Article  PubMed  PubMed Central  Google Scholar 

  16. Okulu E, Ener K, Aldemir M, Isik E, Irkkan C, Kayigil O (2014) Primary mature cystic teratoma mimicking an adrenal mass in an adult male patient. Korean journal of urology 55 (2):148–151. doi:10.4111/kju.2014.55.2.148

    Article  PubMed  PubMed Central  Google Scholar 

  17. Powell G, Burrows C, Houghton A, Otter M (2012) An incidental peri-adrenal cystic lesion. BMJ case reports 2012. doi:10.1136/bcr-2012-006606

  18. Guo YK, Yang ZG, Li Y, Deng YP, Ma ES, Min PQ, Zhang XC (2007) Uncommon adrenal masses: CT and MRI features with histopathologic correlation. European journal of radiology 62 (3):359–370. doi:10.1016/j.ejrad.2006.12.011

    Article  PubMed  Google Scholar 

  19. Angeli A, Osella G, Ali A, Terzolo M (1997) Adrenal incidentaloma: an overview of clinical and epidemiological data from the National Italian Study Group. Horm Res 47 (4–6):279–283

    Article  PubMed  CAS  Google Scholar 

  20. Nadeem M, Ather MH, Sulaiman MN, Pervez S (2015) “Looks Can Be Deceiving”: adrenal teratoma causing diagnostic difficulty. Case Rep Urol 2015:232591. doi:10.1155/2015/232591

    Article  PubMed  PubMed Central  Google Scholar 

  21. Reuter VE (2005) Origins and molecular biology of testicular germ cell tumors. Mod Pathol 18 Suppl 2:S51–60. doi:10.1038/modpathol.3800309

    Article  PubMed  CAS  Google Scholar 

  22. Mostert MC, Verkerk AJ, van de Pol M, Heighway J, Marynen P, Rosenberg C, van Kessel AG, van Echten J, de Jong B, Oosterhuis JW, Looijenga LH (1998) Identification of the critical region of 12p over-representation in testicular germ cell tumors of adolescents and adults. Oncogene 16 (20):2617–2627. doi:10.1038/sj.onc.1201787

    Article  PubMed  CAS  Google Scholar 

  23. Gurda GT, VandenBussche CJ, Yonescu R, Gonzalez-Roibon N, Ellis CL, Batista DA, Netto GJ (2014) Sacrococcygeal teratomas: clinico-pathological characteristics and isochromosome 12p status. Mod Pathol 27 (4):562–568. doi:10.1038/modpathol.2013.171

    Article  PubMed  CAS  Google Scholar 

  24. Masiakos PT, Gerstle JT, Cheang T, Viero S, Kim PC, Wales P (2004) Is surgery necessary for incidentally discovered adrenal masses in children? J Pediatr Surg 39 (5):754–758

    Article  PubMed  Google Scholar 

  25. Polo JL, Villarejo PJ, Molina M, Yuste P, Menendez JM, Babe J, Puente S (2004) Giant mature cystic teratoma of the adrenal region. AJR American journal of roentgenology 183 (3):837–838. doi:10.2214/ajr.183.3.1830837

    Article  PubMed  Google Scholar 

  26. Shrestha MK, Lalchan S (2010) Adrenal gland teratoma in a 40-year-old woman. Nepal Medical College Journal: NMCJ 12 (3):201–202

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This publication was supported in part by the H H Lee Research Program.

Author information

Authors and Affiliations

  1. Section of Endocrine Surgery, UCLA David Geffen School of Medicine, 10833 Le Conte Ave, 72-228 CHS, Los Angeles, CA, 90095, USA

    Eric J. Kuo, Michael W. Yeh & Masha J. Livhits

  2. Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Anthony E. Sisk, Zhiming Yang & Jiaoti Huang

Authors
  1. Eric J. Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony E. Sisk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiming Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiaoti Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael W. Yeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masha J. Livhits
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masha J. Livhits.

Ethics declarations

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kuo, E.J., Sisk, A.E., Yang, Z. et al. Adrenal Teratoma: a Case Series and Review of the Literature. Endocr Pathol 28, 152–158 (2017). https://doi.org/10.1007/s12022-017-9468-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12022-017-9468-5

Keywords

Search

Navigation