Retroperitoneal teratomas—potential for surgical misadventure

BackgroundRetroperitoneal teratoma (RPT) is a relatively uncommon tumor in children. This study concerns 6 children with RPT that involved surrounding structures and required rather extensive operative procedures to successfully excise the lesions.MethodsA review of RPT in children encountered at a single institution over an 8-year period by a single surgeon was carried out. Age at presentation, sex, operative findings, surgical management, and outcomes were evaluated.ResultsFour of the 6 patients were girls, and 5 were younger than 6 months at diagnosis. All of the tumors enveloped and displaced the aorta and vena cava, 1 involved the stomach wall, 2 others displaced the renal vessels, and 1 the portal vein. Extensive resection including major vessel ligation was necessary for complete excision. All the tumors were benign, but 1 recurred. There were no deaths; however, 2 children have persistent hypertension.ConclusionsThe operative management of RPTs may be complex and challenging. Despite their benign nature, the lesions can attenuate and surround major vessels, making resection difficult. Ligation of major vessels when necessary is tolerated well and may be required for complete tumor excision.