>Cirugía y Cirujanos
>Year 2009, Issue 5
Arias-Garzón W, Ramírez-Durini L, Lugo-Soria P, Salgado-Macías N
Teratoma sólido maduro de ovario con protrusión intrarrectal. Informe de un caso
Cir Cir 2009; 77 (5)
PDF: 138.18 Kb.
Background: Primary rectal teratoma is a very rare entity. It has been suggested that these tumors grow from aberrant germinal cells of the embryonic digestive tract. Ovarian tumor can also erode the rectal wall, allowing the formation of a fistula localized inside the rectum, becoming an extremely rare complication.
Clinical case: We report the first case of a 54-year old woman with transanal bleeding whose endoscopic investigation showed a hairy-covered tumor in its surface localized 15 cm from the anal margin. A scanning detected its exact location and the presence of bony tissue within. By means of a laparotomy, we identified the left ovary fusioned to the anterior face of the rectum where a 5 × 4 cm tumor was originally protruding towards its lumen. Left oophorectomy was performed and through a peritumoral section of the intestinal wall we extracted the tumor from the inner rectum and closed the defect with simple sutures. Histological report demonstrated a conglomerate of tissues that corresponded to the three germinal layers.
Conclusions: Although rare, diagnosis of intrarectal ovarian teratoma must be considered as a differential diagnosis in patients with rectal tumors. Diagnosis is relatively easy in the presence of a tumor with a hairy surface that is evaluated endoscopically. For treatment we suggest a simple procedure with adequate results.
||Mature teratoma, ovarian tumors, rectal teratoma.
Berek JS, Hacker NF. Practical Gynecologic Oncology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 229.
Kiryabwire M, Mugerwa W. Teratoma of the liver in an African child. Br J Surg 1967;54:585-587.
Soysal Ò, Saraç K, Kutlu R, Aydin A, Benli A. A case of mediastinal teratoma presenting as a cystic lesion on chest wall. Eastern J Med 1998;3:32-33.
Gray D, Hitchcock G. Benign cystic teratoma of the fallopian tube. Br J Surg 1969;56:475-476.
Kay S. Teratoid cyst of the cecum. Dig Dis 1971;16:265-268.
Gowdy JM. Dermoid cyst of the cecum. Gastroenterology 1956;31:447-450.
El-Katib Y. Pedunculated teratoma of rectum infested with bilharziasis. Br J Sur 1972;59:655-657.
Kumar B, Kumar M, Sen R, Anchal N. Mature solid teratoma of the rectum: report of a case. Surg Today 2008;38:1133-1136.
Elsheikh T, Schuetz MJ. Dermoid cyst (mature cystic teratoma) of the cecum: histologic and cytologic features with review of the literature. Arch Pathol Laboratory Med 2002;126:97-99.
Takao Y, Shimamoto C, Hazama K, Itakura H, Sasaki S, Umegaki E, et al. Primary rectal teratoma: EUS features and review of the literature. Gastrointest Endosc 2000;51:353-355.
Tabuchi Y, Tsunemi K, Matsuda T. Variant type of teratoma appearing as a primary solid dermoid tumor in the rectum: report of a case. Surg Today 1995;25:68-71.
Shah R, Kaddu S, Kirtane J. Benign mature teratoma of the large bowel: a case report. Pediatr Surg 1996;31:701-702.
Deborshi S, Sanjeev K, Ashutosh T, Amrita G, Mohan K, Shukla VK. Primary rectal teratoma. Surgery 2008;143:570-571.
Park H, Park S, Kim W, Park J. Ovarian teratoma presenting as a pedunculated colonic polyp. Endoscopy 2006;38:E36.
Landmann DD, Lewis RW. Benign cystic ovarian teratoma with colorectal involvement: report of a case and review of the literature. Dis Colon Rectum 1988;31:808-813.
Bal A, Mohan H, Singh SB, Sehgal A. Malignant transformation in mature cystic teratoma of the ovary: report of five cases and review of the literature. Arch Gynecol Obstet 2007;275:179-182.
Russell P. Carcinoma complicating a benign teratoma of the rectum: report of case. Dis Col Rectum 1974;17:550-553.
Green JB, Timmcke AE, Mitchell WT Jr. Endoscopic resection of primary rectal teratoma. Am Surg 1993;59:270-272.
>Cirugía y Cirujanos
>Year 2009, Issue 5