br Methods br Results The results

Methods
Results The results of the study are shown in Table 1. There were eight patients with gastric teratomas and all of them were male. Their ages ranged from 1 day to 3.5 years. Seven (87.5%) patients presented in infancy, out of which four (50%) were neonates, while one (12.5%) was a toddler. The manifestations were as follows: a palpable abdominal mass in seven (87.5%), abdominal distension in five (67.5%), anemia in four (50%), respiratory distress in three (37.5%), gastric outlet obstruction with recurrent vomiting in three (37.5%), and abdominal pain, anorexia, and melena in one (12.5%) each. Ultrasonography showed a solid cystic with mixed echogenicity mass in all the patients, while calcification was seen in seven (87.5%) cases. CT, which was performed in four (50%) patients, provided classical findings of teratomas, seen as the presence of a well-encapsulated, multiseptate, enhancing, solid cystic mass with areas of calcification (Figure 1) and clinched the preoperative diagnosis. Operative intervention was carried out in all the patients. A growth was present on the posteroinferior wall near the greater curvature in seven (87.5%) cases (Figures 2–4), while in one (12.5%) patient, a growth was arising from the lesser curvature. Tumor was purely exogastric in six (75%) cases, while it was predominantly exogastric with minimal endogastric component in two (25%) patients. buy GLPG0634 of the tumor along with a small fringe of the gastric wall and primary gastric closure was performed in all patients. Histopathology was mature type in six (75%) cases, and immature Grades 1 and 2 in one (12.5%) each. Complications were seen in five (62.5%) cases, and there was one (12.5%) mortality in our series. All other patients were doing well in the postoperative period. Recurrence was not seen in any of our cases.
Discussion The word teratoma is derived from the Greek word “teraton,” meaning “monster.” Teratomas are relatively common embryonic neoplasms arising from totipotent cells and contain elements from all the three germ layers. In infancy and early childhood, the most common site of teratomas is the extragonadal region, which includes sacrococcygeal, mediastinal, presacral and rarely intracranial, retroperitoneal, and cervical regions, whereas after childhood, they are more usually located in the gonads. Gastric teratomas, a unique subgroup of teratomas, present especially in neonates and infants. It was first reported in 1922 by Eustermann and Sentry. The exact cause of gastric teratomas is not known, and, similar to other extragonadal teratomas, it has been proposed to originate from migrated totipotential germ cells. It commonly presents in a neonatal age group, which was seen in 50% of our cases. Late presentation beyond infancy was seen in one of our patients. It has also been reported in the adult age group. The most common presentation is a palpable abdominal mass (75%) in the epigastrium and the left side of the abdomen with abdominal distension, as per the literature. The mass is usually bosselated, firm in consistency, and mobile in both directions, and moves with respiration. The reported incidence of the presence of only a distended abdomen is ∼56%. The other presenting features are as follows: hematemesis and melena due to gastrointestinal bleeding in patients in whom the tumor grows intramurally and results in ulceration of the overlying mucosa; feeding problems and respiratory distress due to splinting of the diaphragm as a result of its anatomical location and an enormous size of the tumor; vomiting due to gastric outlet obstruction; fever; anorexia and constipation; weakness, anemia, and weight loss; and sometimes abdominal pain in the older age group. Spontaneous rupture and perforation of large gastric teratomas have also been reported. Large tumors may cause obstetric complications (polyhydramnios, premature labor, or dystocia) in the perinatal period because of gastric obstruction produced by the mass, as seen in one of our cases.