Retroperitoneoscopic resection of a congenital adrenal teratoma in an infant

We present a case of a 4-month-old boy with a congenital adrenal teratoma. A right suprarenal cystic mass was detected before birth. Ultrasonography at the age of one day showed a 20-mm suprarenal mass. No blood flow was observed in the mass. It decreased in size over the first ten days after birth, but subsequently increased in size during four months of follow-up. Imaging examinations showed that the mass changed from cystic to solid with areas of adipose tissue. Complete resection of the mass was performed retroperitoneoscopically with preservation of the right adrenal gland. Pathological examination showed a mature teratoma with no immature or malignant elements. There were no postoperative complications. With the growing use of ultrasonography during pregnancy, increasing numbers of neonates present for management of suprarenal masses. In the majority of cases, the mass is a congenital cystic neuroblastoma or adrenal hemorrhagic pseudocyst. Although congenital adrenal teratoma is extremely rare, it should be considered in the differential diagnosis of a neonatal suprarenal mass.