Gastric teratoma in a 7-month-old infant: a case report and review of the literature.

BACKGROUND

Gastric teratomas are exceedingly rare neoplasms, predominantly affecting male infants and constituting less than 1% of all teratomas. Prenatally, their rapid growth can lead to fetal distress syndrome. Postnatally, they may manifest as vomiting or gastric outlet obstruction; however, some cases present as a slowly enlarging abdominal mass without gastrointestinal symptoms.

CASE PRESENTATION: We report the case of a 7-month-old Afghan infant with an asymptomatic abdominal mass. At 3 months of age, a small abdominal mass was noted; however, due to financial constraints, the parents delayed seeking specialized diagnostic and treatment services. At 6 months, as the mass enlarged, the patient was admitted to our pediatric surgery department. In addition to the physical examination, routine and biochemical laboratory tests were performed. Ultrasonography and computed tomography had already been conducted, revealing an abdominal mass with mixed solid, calcified, and cystic components. Laboratory results indicated leukocytosis with anemia. The infection and anemia were managed with broad-spectrum antibiotics and hematinics. The entire course of conservative treatment and preoperative preparation lasted 1 month, by which time the patient had reached 7 months of age. A midline incision was made, and the mass, which was adherent to the greater curvature and gastric fundus, was completely and intactly resected. The stomach was repaired in two layers, and the surgery proceeded without complications. Histological examination revealed mature tissues, including teeth, hair, and bone. Serum alpha-fetoprotein level was within normal limits, confirming the lesion's mature nature. The patient was discharged in good health. Follow-up evaluations were conducted at 3 and 6 months postoperatively, during which no complications or concerns were observed.

CONCLUSION

Gastric teratomas are predominantly mature; however, immature variants do occur in clinical practice. In pediatric patients, especially neonates and infants, teratomas should be considered in the differential diagnosis of abdominal masses. Early management, including tumor marker analysis-particularly serum alpha-fetoprotein levels-and regular follow-up, is essential for favorable outcomes.