Pediatric paraduodenal dermoid cyst: Clinical presentation, minimally invasive management and literature review

Dermoid cysts (mature cystic teratomas) are congenital masses composed of all three germ cell layers: commonly occurring in the head, neck, and gonads and rarely in the abdomen. We present the first documented case of a paraduodenal dermoid cyst in a child, and describe the minimally invasive surgical approach utilized for resection. The patient was an asymptomatic five-month old female diagnosed with a cystic lesion in the posterior mid-abdomen on a prenatal ultrasound, followed up by MRI at three months of age. We proceeded with a laparoscopic resection for both diagnosis and definitive management. Intraoperatively, the lesion was noted to be separate of the pancreas and the stomach, located between the superior mesenteric vessels and splenic vein. It was dissected out with histopathology confirming the diagnosis of a dermoid cyst. We believe that the use of a laparoscopic technique allowed for better post-operative pain control, less overall morbidity and a shorter hospital stay compared to an open approach. Given the significant recurrence rate and possibility of malignant degeneration with incomplete resection, it is imperative to perform a complete resection if this lesion is suspected.