The word teratoma is derived from Greek word “teratomas” meaning “monstrous growth”. Generally, they are composed of tissue related to all the germinal layers. Gastric teratoma was initially described by Eustermann et al in 1922. It is extremely rare tumor and forms 1% of all the teratomas in the body. Gastric teratomas may be mature and immature, based on the presence of immature glial tissue. Mature gastric teratomas contain mature glial tissue along with other derivatives of all germinal layers as found in our case. Mature gastric teratomas are considered benign tumors, whereas, the malignant potential is present in immature gastric teratomas [1
Majority of gastric teratomas are exogastric (>60%); endogastric growths are present in 30% of cases. Mixed exogastric and endogastric growths are rare [1
]. In our case the main component of the mass was exogastric (90%) whereas a small proportion was endogastric which was detected by palpating the gastric lumen before its excision.
The main clinical features are abdominal distension, a palpable mass in the epigastrium and left abdomen, vomiting, and respiratory distress. In case of endogastric component there may be additional upper alimentary tract bleeding (hemetemesis and melena), and pain abdomen [1
]. In our case the main presentation was a palpable abdominal mass with occasional emesis.
Abdominal radiograph, ultrasonography, CT/MRI, and endoscopy are important diagnostic tools. In most of the cases the preoperative diagnosis of gastric teratomas is difficult. Our preoperative diagnosis was gastric teratoma based upon our previous experience of dealing with immature gastric teratoma, age of the patient, and location in relation to the stomach.
Gastroscopy in case of endogastric component may aid in the preoperative diagnosis. Complete excision with tumor free margins is the goal. Long term follow up for recurrence is important. Recurrence in a case of completely excised mature gastric teratoma is seldom reported [4